CA2746425C - Clostridial toxin pharmaceutical compositions - Google Patents

Clostridial toxin pharmaceutical compositions Download PDF

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CA2746425C
CA2746425C CA2746425A CA2746425A CA2746425C CA 2746425 C CA2746425 C CA 2746425C CA 2746425 A CA2746425 A CA 2746425A CA 2746425 A CA2746425 A CA 2746425A CA 2746425 C CA2746425 C CA 2746425C
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clostridial toxin
active ingredient
pharmaceutical composition
poloxamer
pvp
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CA2746425A1 (en
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Gopal Dasari
Ananda Seneviratne
Jack Z. Xie
Huong T. Tran
Alex Praseuth
Don Mathewson
Terrence J. Hunt
Harish P. M. Kumar
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Allergan Inc
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    • A—HUMAN NECESSITIES
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    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • A61K38/43—Enzymes; Proenzymes; Derivatives thereof
    • A61K38/46—Hydrolases (3)
    • A61K38/48—Hydrolases (3) acting on peptide bonds (3.4)
    • A61K38/4886—Metalloendopeptidases (3.4.24), e.g. collagenase
    • A—HUMAN NECESSITIES
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    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
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    • A61K38/43—Enzymes; Proenzymes; Derivatives thereof
    • A61K38/46—Hydrolases (3)
    • A61K38/48—Hydrolases (3) acting on peptide bonds (3.4)
    • A61K38/4886—Metalloendopeptidases (3.4.24), e.g. collagenase
    • A61K38/4893—Botulinum neurotoxin (3.4.24.69)
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    • A61K47/18—Amines; Amides; Ureas; Quaternary ammonium compounds; Amino acids; Oligopeptides having up to five amino acids
    • A61K47/183—Amino acids, e.g. glycine, EDTA or aspartame
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    • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/20—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing sulfur, e.g. dimethyl sulfoxide [DMSO], docusate, sodium lauryl sulfate or aminosulfonic acids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/26—Carbohydrates, e.g. sugar alcohols, amino sugars, nucleic acids, mono-, di- or oligo-saccharides; Derivatives thereof, e.g. polysorbates, sorbitan fatty acid esters or glycyrrhizin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/30—Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
    • A61K47/32—Macromolecular compounds obtained by reactions only involving carbon-to-carbon unsaturated bonds, e.g. carbomers, poly(meth)acrylates, or polyvinyl pyrrolidone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/30—Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
    • A61K47/34—Macromolecular compounds obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyesters, polyamino acids, polysiloxanes, polyphosphazines, copolymers of polyalkylene glycol or poloxamers
    • A—HUMAN NECESSITIES
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    • A61K47/30—Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
    • A61K47/36—Polysaccharides; Derivatives thereof, e.g. gums, starch, alginate, dextrin, hyaluronic acid, chitosan, inulin, agar or pectin
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    • A61K9/0012—Galenical forms characterised by the site of application
    • A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
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    • A61K9/14—Particulate form, e.g. powders, Processes for size reducing of pure drugs or the resulting products, Pure drug nanoparticles
    • A61K9/19—Particulate form, e.g. powders, Processes for size reducing of pure drugs or the resulting products, Pure drug nanoparticles lyophilised, i.e. freeze-dried, solutions or dispersions
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    • A61P25/00—Drugs for disorders of the nervous system
    • A61P25/04—Centrally acting analgesics, e.g. opioids
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12Y—ENZYMES
    • C12Y304/00—Hydrolases acting on peptide bonds, i.e. peptidases (3.4)
    • C12Y304/24—Metalloendopeptidases (3.4.24)

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Abstract

Animal protein-free, solid-form Clostridial toxin pharmaceutical compositions comprising a Clostridial toxin ac-tive ingredient and at least two excipients.

Description

CLOSTRIDIAL TOXIN PHARMACEUTICAL COMPOSITIONS
[01]
[02] A pharmaceutical composition is a formulation comprises at least one active ingredient and at least one inert ingredient, called an excipient, used as a diluent or vehicle for the active ingredient. An excipient is useful in one or more of the following as a stabilizing agent, a surfactant, a bulking agent, a cryo-protectant, a lyo-protectant, a preservative, and a buffer. A pharmaceutical composition can be processed into a solid form, such as, e.g., a lyophilized (freeze dried), or vacuum dried powder which can be reconstituted with a suitable fluid, such as saline or water, prior to administration to a patient.
Alternately, a pharmaceutical composition can be formulated as an aqueous solution or suspension.
[03] The vast majority of pharmaceutical compositions include a small molecule (or chemical entity) as their active ingredient. Recently, with the advent of the biotechnology industry, pharmaceutical compositions comprising a protein active ingredient have been, or are currently being, developed. Unfortunately, a protein active ingredient can be very difficult to stabilize (i.e., maintained in a state where loss of biological activity is minimized), thereby resulting in a loss of protein and/or loss of protein activity during the formulation, reconstitution (if required) and storage of the pharmaceutical composition prior to use. Stability problems can arise due to surface adsorption of a protein active ingredient, physical instability, such as, e.g., denaturation or aggregation, or chemical instability, such as, e.g., cross-linking, deamidation, isomerization, oxidation, formation of acidic or basic species, Maillard reaction, and fragmentation. To prevent such instability, various protein-based excipients, such as albumin and gelatin, have been used to stabilize a protein active ingredient present in a pharmaceutical composition.
[04] Unfortunately, despite their known stabilizing effects, significant drawbacks exist to the use of protein excipients, such as albumin or gelatin, in a pharmaceutical composition. For example albumin and gelatin are expensive and increasingly difficult to obtain. Furthermore, blood products or animal derived products such as albumin and gelatin, when administered to a patient can subject the patient to a potential risk of receiving blood borne pathogens or infectious agents. Thus, it is known that the possibility exists that the presence of an animal-derived protein excipient in a pharmaceutical composition can result in inadvertent incorporation of infectious elements into the pharmaceutical composition. For example, it has been reported that use of human serum albumin may transmit prions into a pharmaceutical composition.
Thus, it is desirable to find suitable non-protein excipients, such as, e.g., stabilizers, cryo-protectants and lyo-protectants, which can be used to stabilize the protein active ingredient present in a pharmaceutical composition.
[05] The unique characteristics of Clostridial toxins further constrain and hinder the selection of suitable non-protein excipients for a pharmaceutical composition comprising a Clostridial toxin active ingredient. For example, Clostridial toxins are large proteins having an average molecular weight of approximately 150 kDa, and are further complexed with non-toxin associated proteins that increase the size to approximately 300-900-kDa. The size of a Clostridial toxin complex makes it much more fragile and labile than smaller, less complex proteins, thereby compounding the formulation and handling difficulties if Clostridial toxin stability is to be maintained. Hence, the use of non-protein excipients, such as, e.g., stabilizers, cryo-protectants and lyo-protectants must be able to interact with the Clostridial toxin active ingredient in a manner which does not denature, fragment or otherwise inactivate the toxin or cause disassociation of the non-toxin associated proteins present in the toxin complex.
[06] Another problem associated with a Clostridial toxin active ingredient, is the exceptional safety, precision, and accuracy that is necessary for at all steps of the formulation process. Thus, a non-protein excipient should not itself be toxic or difficult to handle so as to not exacerbate the already extremely stringent requirements currently in place to formulate a pharmaceutical composition comprising a Clostridial toxin active ingredient.
[07] Still another difficulty linked with a Clostridial toxin active ingredient, is the incredible low amounts of Clostridial toxin that is used in a pharmaceutical composition. As with enzymes generally, the biological activities of the Clostridial toxins are dependant, at least in part, upon their three dimensional conformation.
Thus, a Clostridial toxin is detoxified by heat, various chemicals, surface stretching, and surface drying.
Additionally, it is known that dilution of a Clostridial toxin complex obtained by the known culturing, fermentation and purification methods to the much lower concentration used in a pharmaceutical composition results in rapid inactivation of the toxin. The extremely low amount of a Clostridial toxin active ingredient that is used in a pharmaceutical composition, makes this active ingredient very susceptible to adsorption to, e.g., the surfaces of laboratory glassware, vessels, to the vial in which the pharmaceutical composition is reconstituted and to the inside surface of a syringe used to inject the pharmaceutical composition. Such adsorption of a Clostridial toxin active ingredient to surfaces can lead to a loss of active ingredient and to denaturation of the remaining Clostridial toxin active ingredient, both of which reduce the total activity of the active ingredient present in the pharmaceutical composition. Hence, the use of non-protein excipients, such as, e.g., stabilizers, cryo-protectants and lyo-protectants must be able to act as surface blockers to prevent the adsorption of a Clostridial toxin active ingredient to a surface. To date, the only successful stabilizing agent for this purpose has been the animal derived proteins, such as, e.g., human serum albumin and gelatin.
[08] Yet another problem connected to a Clostridial toxin active ingredient, is the pH-sensitivity associates with complex formation. For example, the 900-kDa BoNT/A complex is known to be soluble in dilute aqueous solutions at pH 3.5-6.8. However, at a pH above about 7 the non-toxic associated proteins dissociate from the 150-kDa neurotoxin, resulting in a loss of toxicity, particularly as the pH rises above pH 8Ø See Edward J. Schantz et al., pp. 44-45, Preparation and characterization of botulinum toxin type A for human treatment, in Jankovic, J., et al., THERAPY WITH BOTULINUM TOXIN (Marcel Dekker, Inc., 1994). As the non-toxic associated proteins are believed to preserve or help stabilize the secondary and tertiary structures upon which toxicity is depends, the dissociation of these proteins results in a more unstable Clostridial toxin active ingredient. Thus, non-protein excipients useful to formulate a pharmaceutical composition comprising a Clostridial toxin active ingredient must be able to operate within the confines of a pH level necessary to maintain the activity a Clostridial toxin active ingredient.
[09] In light of the unique nature of Clostridial toxins and the requirements set forth above, the probability of finding suitable non-protein excipients useful to formulate a pharmaceutical composition comprising a Clostridial toxin active ingredient has been difficult. Prior to the present invention, only animal derived protein excipients, such as, e.g., human serum albumin and gelatin, were used successfully as stabilizers. Thus, albumin, by itself or with one or more additional substances such as sodium phosphate or sodium citrate, is known to permit high recovery of toxicity of botulinum toxin type A after lyophilization. Unfortunately, as already set forth, human serum albumin, as a pooled blood product, can, at least potentially, carry infectious or disease causing elements when present in a pharmaceutical composition.
Indeed, any animal product or protein such as human serum albumin or gelatin can also potentially contain pyrogens or other substances that can cause adverse reactions upon injection into a patient.
[010] What is needed therefore is a Clostridial toxin pharmaceutical composition wherein the Clostridia!
toxin (such as a botulinum toxin) is stabilized by a non-protein excipient.
The present invention relates to Clostridial toxin pharmaceutical compositions with one or more non-protein excipients which functions to stabilize the Clostridial toxin present in the pharmaceutical composition.
[011] Thus, in an aspect of the present invention, a Clostridial toxin pharmaceutical composition comprises an animal protein-free excipient and a Clostridial toxin active ingredient. In another aspect, a Clostridial toxin pharmaceutical composition comprises at least two an animal protein-free excipients and a Clostridial toxin active ingredient. In yet another aspect, a Clostridial toxin pharmaceutical composition comprises at least three an animal protein-free excipients and a Clostridial toxin active ingredient. A Clostridial toxin active ingredient can be a Clostridial toxin complex comprising the approximately 150-kDa Clostridial toxin and other proteins collectively called non-toxin associated proteins (NAPs), the approximately 150-kDa Clostridial toxin alone, or a modified Clostridial toxin, such as, e.g., a re-targeted Clostridia! toxin.
[012] Thus, in an aspect of the present invention, a Clostridial toxin pharmaceutical composition comprises a non-protein-based excipient and a Clostridial toxin active ingredient. In another aspect, a Clostridial toxin pharmaceutical composition comprises at least two non-protein-based excipients and a Clostridial toxin active ingredient. In yet another aspect, a Clostridial toxin pharmaceutical composition comprises at least three non-protein-based excipients and a Clostridial toxin active ingredient. A
Clostridial toxin active ingredient can be a Clostridial toxin complex comprising the approximately 150-kDa Clostridial toxin and other proteins collectively called non-toxin associated proteins (NAPs), the approximately 150-kDa Clostridial toxin alone, or a modified Clostridial toxin, such as, e.g., a re-targeted Clostridia! toxin.
[013] In another aspect of the present invention, a Botulinum toxin pharmaceutical composition comprises an animal protein-free excipient and a Botulinum toxin active ingredient. In another aspect, a Botulinum toxin pharmaceutical composition comprises at least two animal protein-free excipients and a Botulinum toxin active ingredient. In yet another aspect, a Botulinum toxin pharmaceutical composition comprises at least three animal protein-free excipients and a Botulinum toxin active ingredient.
A Botulinum toxin active ingredient can be a Botulinum toxin complex comprising the approximately 150-kDa botulinum toxin and NAPs, the 150-kDa Botulinum toxin alone, or a modified Botulinum toxin, or a Targeted Vesicular Exocytosis Modulating Protein (TVEMP), such as, e.g., a re-targeted Clostridia! toxin.
[014] In another aspect of the present invention, a Botulinum toxin pharmaceutical composition comprises a non-protein-based excipient and a Botulinum toxin active ingredient. In another aspect, a Botulinum toxin pharmaceutical composition comprises at least two non-protein-based excipients and a Botulinum toxin active ingredient. In yet another aspect, a Botulinum toxin pharmaceutical composition comprises at least three non-protein-based excipients and a Botulinum toxin active ingredient. A Botulinum toxin active ingredient can be a Botulinum toxin complex comprising the approximately 150-kDa botulinum toxin and NAPs, the 150-kDa Botulinum toxin alone, or a modified Botulinum toxin, such as, e.g., a re-targeted botulinum toxin.
[015] Clostridia toxins produced by Clostridium botulinum, Clostridium tetani, Clostridium baratii and Clostridium butyricum are the most widely used in therapeutic and cosmetic treatments of humans and other mammals. Strains of C. botulinum produce seven antigenically-distinct types of Botulinum toxins (BoNTs), which have been identified by investigating botulism outbreaks in man (BoNT/A, /B, /E and /F), animals (BoNT/Ci and /D), or isolated from soil (BoNT/G). BoNTs possess approximately 35% amino acid identity with each other and share the same functional domain organization and overall structural architecture. It is recognized by those of skill in the art that within each type of Clostridial toxin there can be subtypes that differ somewhat in their amino acid sequence, and also in the nucleic acids encoding these proteins. For example, there are presently five BoNT/A subtypes, BoNT/A1, BoNT/A2, BoNT/A3, BoNT/A4 and BoNT/A5, with specific subtypes showing approximately 89% amino acid identity when compared to another BoNT/A
subtype. While all seven BoNT serotypes have similar structure and pharmacological properties, each also displays heterogeneous bacteriological characteristics. In contrast, tetanus toxin (TeNT) is produced by a uniform group of C. tetani. Two other species of Clostridia, C. baratii and C.
butyricum, also produce toxins, BaNT and BuNT respectively, which are similar to BoNT/F and BoNT/E, respectively.
[016] Clostridial toxins are released by Clostridial bacterium as complexes comprising the approximately 150-kDa Clostridial toxin along with associated non-toxin proteins (NAPs).
Identified NAPs include proteins possessing hemaglutination activity, such, e.g., a hemagglutinin of approximately 17-kDa (HA-17), a hemagglutinin of approximately 33-kDa (HA-33) and a hemagglutinin of approximately 70-kDa (HA-70); as well as non-toxic non-hemagglutinin (NTNH), a protein of approximately 130-kDa, see, e.g., Eric A. Johnson and Marite Bradshaw, Clostridial botulinum and its Neurotoxins: A Metabolic and Cellular Perspective, 39 Toxicon 1703-1722 (2001); and Stephanie Raffestin et al., Organization and Regulation of the Neurotoxin Genes in Clostridium botulinum and Clostridium tetani, 10 Anaerobe 93-100 (2004). Thus, the botulinum toxin type A complex can be produced by Clostridial bacterium as 900-kDa, 500-kDa and 300-kDa forms.
Botulinum toxin types B and Ci are apparently produced as only a 500-kDa complex. Botulinum toxin type D
is produced as both 300-kDa and 500-kDa complexes. Finally, botulinum toxin types E and F are produced as only approximately 300-kDa complexes. The differences in molecular weight for the complexes are due to differing ratios of NAPs. The toxin complex is important for the intoxication process because it provides protection from adverse environmental conditions, resistance to protease digestion, and appears to facilitate internalization and activation of the toxin.
[017] Clostridial toxins are each translated as a single chain polypeptide that is subsequently cleaved by proteolytic scission within a disulfide loop by a naturally-occurring protease. This cleavage occurs within the discrete di-chain loop region created between two cysteine residues that form a disulfide bridge. This posttranslational processing yields a di-chain molecule comprising an approximately 50 kDa light chain (LC) and an approximately 100 kDa heavy chain (HC) held together by the single disulfide bond and non-covalent interactions between the two chains. The naturally-occurring protease used to convert the single chain molecule into the di-chain is currently not known. In some serotypes, such as, e.g., BoNT/A, the naturally-occurring protease is produced endogenously by the bacteria serotype and cleavage occurs within the cell before the toxin is release into the environment. However, in other serotypes, such as, e.g., BoNT/E, the bacterial strain appears not to produce an endogenous protease capable of converting the single chain form of the toxin into the di-chain form. In these situations, the toxin is released from the cell as a single-chain toxin which is subsequently converted into the di-chain form by a naturally-occurring protease found in the environment.
Table 1. Clostridial Toxin Reference Sequences and Regions Hc Toxin SEQ ID NO: LC HN
BoNT/A 1 M1-K448 A449-1873 1874-P1110 BoNT/B 2 M1-K441 A442-1860 L861-E1097 BoNT/C1 3 M1-K449 T450-1868 N869-E1111 BoNT/D 4 M1-R445 D446-1864 N865-E1098 BoNT/E 5 M1-R422 K423-1847 K848-E1085 BoNT/F 6 M1-K439 A440-1866 K867-K1105 BoNT/G 7 M1-K446 S447-1865 S866-Q1105 TeNT 8 M1-A457 S458-L881 K882-E1127 BaNT 9 M1-K431 N432-1857 1858-K1094 BuNT 10 M1-R422 K423-1847 K848-E1085
[018] Each mature di-chain molecule comprises three functionally distinct domains: 1) an enzymatic domain located in the LC that includes a metalloprotease region containing a zinc-dependent endopeptidase activity which specifically targets core components of the neurotransmitter release apparatus; 2) a translocation domain contained within the amino-terminal half of the HC (HN) that facilitates release of the LC from intracellular vesicles into the cytoplasm of the target cell; and 3) a binding domain found within the carboxyl-terminal half of the HC (1-1c) that determines the binding activity and binding specificity of the toxin to the receptor complex located at the surface of the target cell. The I-10 domain comprises two distinct structural features of roughly equal size that indicate function and are designated the HON and Hoo subdomains. Table 1 gives approximate boundary regions for each domain and subdomain found in exemplary Clostridia! toxins.
[019] The binding, translocation and enzymatic activity of these three functional domains are all necessary for toxicity. While all details of this process are not yet precisely known, the overall cellular intoxication mechanism whereby Clostridial toxins enter a neuron and inhibit neurotransmitter release is similar, regardless of type. Although the applicants have no wish to be limited by the following description, the intoxication mechanism can be described as comprising at least four steps: 1) receptor binding, 2) complex internalization, 3) light chain translocation, and 4) enzymatic target modification. The process is initiated when the I-10 domain of a Clostridial toxin binds to a toxin-specific receptor complex located on the plasma membrane surface of a target cell. The binding specificity of a receptor complex is thought to be achieved, in part, by specific combinations of gangliosides and protein receptors that appear to distinctly comprise each Clostridial toxin receptor complex. Once bound, the toxin/receptor complexes are internalized by endocytosis and the internalized vesicles are sorted to specific intracellular routes. The translocation step appears to be triggered by the acidification of the vesicle compartment. This process seems to initiate two important pH-dependent structural rearrangements that increase hydrophobicity and promote formation di-chain form of the toxin. Once activated, light chain endopeptidase of the toxin is released from the intracellular vesicle into the cytosol where it specifically targets one of three known core components of the neurotransmitter release apparatus. These core proteins, vesicle-associated membrane protein (VAMP)/synaptobrevin, synaptosomal-associated protein of 25 kDa (SNAP-25) and Syntaxin, are necessary for synaptic vesicle docking and fusion at the nerve terminal and constitute members of the soluble N-ethylmaleimide-sensitive factor-attachment protein-receptor (SNARE) family. BoNT/A and BoNT/E cleave SNAP-25 in the carboxyl-terminal region, releasing a nine or twenty-six amino acid segment, respectively, and BoNT/C1 also cleaves SNAP-25 near the carboxyl-terminus. BuNT cleaves at conserved portion of SNAP-25 near the carboxyl-terminus. The botulinum serotypes BoNT/B, BoNT/D, BoNT/F and BoNT/G, TeNT, and BaNT act on the conserved central portion of VAMP, and release the amino-terminal portion of VAMP into the cytosol. BoNT/Ci cleaves syntaxin at a single site near the cytosolic membrane surface. The selective proteolysis of synaptic SNAREs accounts for the block of neurotransmitter release caused by Clostridial toxins in vivo. The SNARE protein targets of Clostridial toxins are common to exocytosis in a variety of non-neuronal types; in these cells, as in neurons, light chain peptidase activity inhibits exocytosis, see, e.g., Yann Humeau et al., How Botulinum and Tetanus Neurotoxins Block Neurotransmitter Release, 82(5) Biochimie. 427-446 (2000);
Kathryn Turton et al., Botulinum and Tetanus Neurotoxins: Structure, Function and Therapeutic Utility, 27(11) Trends Biochem. Sci.
552-558. (2002); Giovanna Lalli et al., The Journey of Tetanus and Botulinum Neurotoxins in Neurons, 11(9) Trends Microbiol. 431-437, (2003).
[020] The ability of Clostridial toxins, such as, e.g., BoNT/A, BoNT/B, BoNT/Ci, BoNT/D, BoNT/E, BoNT/F
and BoNT/G, TeNT, BaNT and BuNT to inhibit neuronal transmission are being exploited in a wide variety of therapeutic and cosmetic applications, see e.g., William J. Lipham, COSMETIC
AND CLINICAL APPLICATIONS OF
BOTULINUM TOXIN (Slack, Inc., 2004). Clostridial toxins commercially available as pharmaceutical compositions include, BoNT/A preparations, such as, e.g., BOTOX (Allergen, Inc., Irvine, CA), DYSPORT /RELOXIN , (Beaufour Ipsen, Porton Down, England), NEURONOX (Medy-Tox, Inc., Ochang-myeon, South Korea), BTX-A (Lanzhou Institute Biological Products, China) and XEOMIN (Merz Pharmaceuticals, GmbH., Frankfurt, Germany); and BoNT/B preparations, such as, e.g., MYOBLOCTm/NEUROBLOCTm (Solstice Neurosciences, Inc., South San Francisco, California). As an example, BOTOX is currently approved in one or more countries for the following indications: achalasia, adult spasticity, anal fissure, back pain, blepharospasm, bruxism, cervical dystonia, essential tremor, glabellar lines or hyperkinetic facial lines, headache, hemifacial spasm, hyperactivity of bladder, hyperhidrosis, juvenile cerebral palsy, multiple sclerosis, myoclonic disorders, nasal labial lines, spasmodic dysphonia, strabismus and VII nerve disorder.
[021] Aspects of the present pharmaceutical compositions provide, in part, a Clostridial toxin pharmaceutical composition. As used herein, the term "Clostridial toxin pharmaceutical composition" refers to a formulation in which an active ingredient is a Clostridia! toxin. As used herein, the term "formulation" means that there is at least one additional ingredient in the pharmaceutical composition besides a Clostridial toxin active ingredient. A pharmaceutical composition is therefore a formulation which is suitable for diagnostic or therapeutic administration to a subject, such as a human patient. The pharmaceutical composition can be a solid formulation, such as, e.g., lyophilized (freeze-dried) or vacuum dried condition, or an aqueous formulation. The constituent ingredients of a pharmaceutical composition can be included in a single composition (that is all the constituent ingredients, except for any required reconstitution fluid, are present at the time of initial compounding of the pharmaceutical composition) or as a two-component system, for example a vacuum-dried composition reconstituted with a diluent such as saline which diluent contains an ingredient not present in the initial compounding of the pharmaceutical composition. A two-component system provides the benefit of allowing incorporation of ingredients which are not sufficiently compatible for long-term shelf storage with the first component of the two component system.
For example, the reconstitution vehicle or diluent may include a preservative which provides sufficient protection against microbial growth for the use period, for example one-week of refrigerated storage, but is not present during the two-year freezer storage period during which time it might degrade the toxin. Other ingredients, which may not be compatible with a Clostridial toxin active ingredient or other ingredients for long periods of time, may be incorporated in this manner; that is, added in a second vehicle (i.e.
in the reconstitution fluid) at the approximate time of use.
[022] Aspects of the present pharmaceutical compositions provide, in part, animal protein-free. Clostridial toxin pharmaceutical composition. As used herein, the term "animal protein-free" refers to the absence of blood-derived, blood-pooled and other animal-derived products or compounds. As used herein, the term "animal" refers to a mammal, bird, amphibian, reptile, fish, arthropod, or other animal species. "Animal"
excludes plants and microorganisms, such as, e.g., yeast and bacteria. For example, an animal protein-free pharmaceutical composition can be a pharmaceutical composition which is either substantially free or essentially free or entirely free of a serum derived albumin, gelatin and other animal-derived proteins, such as, e.g., immunoglobulins. As used herein, the term "entirely free" (or "consisting of" terminology) means that within the detection range of the instrument or process being used, the substance cannot be detected or its presence cannot be confirmed. As used herein, the term "essentially free" (or "consisting essentially or) means that only trace amounts of the substance can be detected. As used herein, the term "substantially free" means present at a level of less than one percent by weight of the pharmaceutical composition. As used herein, the term "animal-derived" refers to any compounds or products purified directly from an animal source.

As such, an animal protein recombinantly produced from a microorganism is excluded from the term "animal-derived product or compound." Thus, animal protein-free Clostridial toxin pharmaceutical compositions can include any of the Clostridial neurotoxin active ingredients disclosed in the present specification. As a non-limiting example of an animal protein-free Clostridial toxin pharmaceutical composition is a pharmaceutical composition comprising a BoNT/A toxin as the active ingredient and a suitable sugar and surfactant as excipients. As another non-limiting example of an animal protein-free Clostridial toxin pharmaceutical composition is a pharmaceutical composition comprising a 900-kDa BoNT/A toxin complex as the active ingredient and a suitable sugar and surfactant as excipients. As yet another non-limiting example of an animal protein-free Clostridial toxin pharmaceutical composition is a pharmaceutical composition comprising a modified BoNT/A toxin including an additional di-leucine motif as the active ingredient and a suitable sugar and surfactant as excipients. As still another non-limiting example of an animal protein-free Clostridial toxin pharmaceutical composition is a pharmaceutical composition comprising a re-targeted BoNT/A including an opioid peptide targeting moiety as the active ingredient and a suitable sugar and surfactant as excipients.
[023] Aspects of the present pharmaceutical compositions provide, in part, a Clostridial toxin active ingredient. As used herein, the term "Clostridial toxin active ingredient"
refers to a therapeutically effective concentration of a Clostridial toxin active ingredient, such as, e.g., a Clostridial toxin complex, a Clostridial toxin, a modified Clostridial toxin, or a re-targeted Clostridia! toxin. As used herein, the term "therapeutically effective concentration" is synonymous with "therapeutically effective amount," "effective amount," "effective dose," and "therapeutically effective dose" and refers to the minimum dose of a Clostridial toxin active ingredient necessary to achieve the desired therapeutic effect and includes a dose sufficient to reduce a symptom associated with aliment being treated. In aspects of this embodiment, a therapeutically effective concentration of a Clostridial toxin active ingredient reduces a symptom associated with the aliment being treated by, e.g., at least 10%, at least 20%, at least 30%, at least 40%, at least 50%, at least 60%, at least 70%, at least 80%, at least 90% or at least 100%. In other aspects of this embodiment, a therapeutically effective concentration of a Clostridial toxin active ingredient reduces a symptom associated with the aliment being treated by, e.g., at most 10%, at most 20%,at most 30%, at most 40%, at most 50%, at most 60%, at most 70%, at most 80%, at most 90% or at most 100%.
[024] It is envisioned that any amount of Clostridial toxin active ingredient can be added in formulating a Clostridial toxin pharmaceutical compositions disclosed in the present specification, with the proviso that a therapeutically effective amount of Clostridial toxin active ingredient is recoverable. In aspects of this embodiment, the amount of Clostridial toxin active ingredient added to the formulation is at least 0.001 U/kg, at least 0.01 U/kg, at least 0.1 U/kg, at least 1.0 U/kg, at least 10 U/kg, at least 100 U/kg, or at least 1000 U/kg. In other aspects of this embodiment, the amount of Clostridial toxin active ingredient added to the formulation is at most 0.001 U/kg, at most 0.01 U/kg, at most 0.1 U/kg, at most 1.0 U/kg, at most 10 U/kg, at most 100 U/kg, or at most 1000 U/kg. In yet other aspects of this embodiment, the amount of Clostridial toxin active ingredient added to the formulation is from about 0.001 U/kg to about 1000 U/kg, about 0.01 U/kg to about 1000 U/kg, about 0.1 U/kg to about 1000 U/kg, or about 1.0 U/kg to about 1000 U/kg. In still other aspects of this embodiment, the amount of Clostridial toxin active ingredient added to the formulation is from about 0.001 U/kg to about 100 U/kg, about 0.01 U/kg to about 100 U/kg, about 0.1 U/kg to about 100 U/kg, or about 1.0 U/kg to about 100 U/kg. As used herein, the term "unit" or "U" is refers to the LD50 dose, which is defined as the amount of a Clostridia! toxin, Clostridial toxin complex or modified Clostridial toxin that killed 50% of the mice injected with the Clostridia! toxin, Clostridial toxin complex or modified Clostridia! toxin. As used herein, the term "about" when qualifying a value of a stated item, number, percentage, or term refers to a range of plus or minus ten percent of the value of the stated item, percentage, parameter, or term.
[025] In other aspects of this embodiment, the amount of Clostridial toxin active ingredient added to the formulation is at least 1.0 pg, at least 10 pg, at least 100 pg, at least 1.0 ng, at least 10 ng, at least 100 ng, at least 1.0 pg, at least 10 pg, at least 100 pg, or at least 1.0 mg. In still other aspects of this embodiment, the amount of Clostridial toxin active ingredient added to the formulation is at most 1.0 pg, at most 10 pg, at most 100 pg, at most 1.0 ng, at most 10 ng, at most 100 ng, at most 1.0 pg, at most 10 pg, at most 100 pg, or at most 1.0 mg. In still other aspects of this embodiment, the amount of Clostridial toxin active ingredient added to the formulation is about 1.0 pg to about 10 pg, about 10 pg to about 10 pg, about 100 pg to about 10 pg, about 1.0 ng to about 10 pg, about 10 ng to about 10 pg, or about 100 ng to about 10 pg. In still other aspects of this embodiment, the amount of Clostridial toxin active ingredient added to the formulation is about 1.0 pg to about 1.0 pg, about 10 pg to about 1.0 pg, about 100 pg to about 1.0 pg, about 1.0 ng to about 1.0 pg, about 10 ng to about 1.0 pg, or about 100 ng to about 1.0 pg. In further aspects of this embodiment, the amount of Clostridial toxin active ingredient added to the formulation is about 1.0 pg to about 5.0 pg, about 10 pg to about 5.0 pg, about 100 pg to about 5.0 pg, about 1.0 ng to about 5.0 pg, about 10 ng to about 5.0 pg, or about 100 ng to about 5.0 pg. In further aspects of this embodiment, the amount of Clostridial toxin active ingredient added to the formulation is about 1.0 pg to about 10 pg, about 10 pg to about 10 pg, about 100 pg to about 10 pg, about 1.0 ng to about 10 pg, about 10 ng to about 10 pg, or about 100 ng to about 10 pg.
[026] Aspects of the present pharmaceutical compositions provide, in part, a Clostridial toxin as a Clostridial toxin active ingredient. As used herein, the term "Clostridial toxin" refers to any neurotoxin produced by a Clostridial toxin strain that can execute the overall cellular mechanism whereby a Clostridial toxin intoxicates a cell and encompasses the binding of a Clostridial toxin to a low or high affinity Clostridial toxin receptor, the internalization of the toxin/receptor complex, the translocation of the Clostridial toxin light chain into the cytoplasm and the enzymatic modification of a Clostridial toxin substrate. Non-limiting examples of Clostridial toxins include a Botulinum toxin like BoNT/A, a BoNT/B, a BoNT/Ci, a BoNT/D, a BoNT/E, a BoNT/F, a BoNT/G, a Tetanus toxin (TeNT), a Baratii toxin (BaNT), and a Butyricum toxin (BuNT). The BoNT/C2 cytotoxin and BoNT/C3 cytotoxin, not being neurotoxins, are excluded from the term "Clostridia! toxin."
Clostridial toxins can be obtained from, e.g., List Biological Laboratories, Inc. (Campbell, California), the Centre for Applied Microbiology and Research (Porton Down, U.K), Wako (Osaka, Japan), and Sigma Chemicals (St Louis, Missouri). In addition, Clostridial toxins can be produced using standard purification or recombinant biology techniques known to those skilled in the art. For example, using the Schantz process, NAPs can be separated out to obtain purified toxin , such as e.g., BoNT/A with an approximately 150 kD
molecular weight with a specific potency of 1-2 X 108 LD50 U/mg or greater, purified BoNT/B with an approximately 156 kD molecular weight with a specific potency of 1-2 X 108 LD50 U/mg or greater, and purified BoNT/F with an approximately 155 kD molecular weight with a specific potency of 1-2 X 107 LD50 U/mg or greater. See Edward J. Schantz & Eric A. Johnson, Properties and use of Botulinum Toxin and Other Microbial Neurotoxins in Medicine, Microbiol Rev. 56: 80-99 (1992). As another example, recombinant Clostridial toxins can be recombinantly produced as described in Lance E.
Steward et al., Optimizing Expression of Active Botulinum Toxin Type A, U.S. Patent Publication 2008/0057575; and Lance E. Steward et al., Optimizing Expression of Active Botulinum Toxin Type E, U.S. Patent Publication 2008/0138893.
[027] A Clostridial toxin includes, without limitation, naturally occurring Clostridial toxin variants, such as, e.g., Clostridial toxin isoforms and Clostridial toxin subtypes; non-naturally occurring Clostridial toxin variants, such as, e.g., conservative Clostridial toxin variants, non-conservative Clostridial toxin variants, Clostridial toxin chimeric variants and active Clostridial toxin fragments thereof, or any combination thereof. As used herein, the term "Clostridial toxin variant," whether naturally-occurring or non-naturally-occurring, refers to a Clostridial toxin that has at least one amino acid change from the corresponding region of the disclosed reference sequences (see Table 1) and can be described in percent identity to the corresponding region of that reference sequence. As non-limiting examples, a BoNT/A variant comprising amino acids 1-1296 of SEQ
ID NO: 1 will have at least one amino acid difference, such as, e.g., an amino acid substitution, deletion or addition, as compared to the amino acid region 1-1296 of SEQ ID NO: 1; a BoNT/B variant comprising amino acids 1-1291 of SEQ ID NO: 2 will have at least one amino acid difference, such as, e.g., an amino acid substitution, deletion or addition, as compared to the amino acid region 1-1291 of SEQ ID NO: 2; a BoNT/C1 variant comprising amino acids 1-1291 of SEQ ID NO: 3 will have at least one amino acid difference, such as, e.g., an amino acid substitution, deletion or addition, as compared to the amino acid region 1-1291 of SEQ ID
NO: 3; a BoNT/D variant comprising amino acids 1-1276 of SEQ ID NO: 4 will have at least one amino acid difference, such as, e.g., an amino acid substitution, deletion or addition, as compared to the amino acid region 1-1276 of SEQ ID NO: 4; a BoNT/E variant comprising amino acids 1-1252 of SEQ ID NO: 5 will have at least one amino acid difference, such as, e.g., an amino acid substitution, deletion or addition, as compared to the amino acid region 1-1252 of SEQ ID NO: 5; a BoNT/F variant comprising amino acids 1-1274 of SEQ ID NO: 6 will have at least one amino acid difference, such as, e.g., an amino acid substitution, deletion or addition, as compared to the amino acid region 1-1274 of SEQ ID
NO: 6; a BoNT/G variant comprising amino acids 1-1297 of SEQ ID NO: 7 will have at least one amino acid difference, such as, e.g., an amino acid substitution, deletion or addition, as compared to the amino acid region 1-1297 of SEQ ID NO:
7; a TeNT variant comprising amino acids 1-1315 of SEQ ID NO: 8 will have at least one amino acid difference, such as, e.g., an amino acid substitution, deletion or addition, as compared to the amino acid region 1-1315 of SEQ ID NO: 8; a BaNT variant comprising amino acids 1-1268 of SEQ ID NO: 9 will have at least one amino acid difference, such as, e.g., an amino acid substitution, deletion or addition, as compared to the amino acid region 1-1268 of SEQ ID NO: 9; and a BuNT variant comprising amino acids 1-1251 of SEQ
ID NO: 10 will have at least one amino acid difference, such as, e.g., an amino acid substitution, deletion or addition, as compared to the amino acid region 1-1251 of SEQ ID NO: 10.
[028] Any of a variety of sequence alignment methods can be used to determine percent identity, including, without limitation, global methods, local methods and hybrid methods, such as, e.g., segment approach methods. Protocols to determine percent identity are routine procedures within the scope of one skilled in the art and from the teaching herein.
[029] Global methods align sequences from the beginning to the end of the molecule and determine the best alignment by adding up scores of individual residue pairs and by imposing gap penalties. Non-limiting methods include, e.g., CLUSTAL W, see, e.g., Julie D. Thompson et al., CLUSTAL
W: Improving the Sensitivity of Progressive Multiple Sequence Alignment Through Sequence Weighting, Position-Specific Gap Penalties and Weight Matrix Choice, 22(22) Nucleic Acids Research 4673-4680 (1994); and iterative refinement, see, e.g., Osamu Gotoh, Significant Improvement in Accuracy of Multiple Protein Sequence Alignments by Iterative Refinement as Assessed by Reference to Structural Alignments, 264(4) J. Mol. Biol.
823-838 (1996).
[030] Local methods align sequences by identifying one or more conserved motifs shared by all of the input sequences. Non-limiting methods include, e.g., Match-box, see, e.g., Eric Depiereux and Ernest Feytmans, Match-Box: A Fundamentally New Algorithm for the Simultaneous Alignment of Several Protein Sequences, 8(5) CABIOS 501-509 (1992); Gibbs sampling, see, e.g., C. E. Lawrence et al., Detecting Subtle Sequence Signals: A Gibbs Sampling Strategy for Multiple Alignment, 262(5131) Science 208-214 (1993); Align-M, see, e.g., Ivo Van Walle et al., Align-M ¨ A New Algorithm for Multiple Alignment of Highly Divergent Sequences, 20(9) Bioinformatics,:1428-1435 (2004).
[031] Hybrid methods combine functional aspects of both global and local alignment methods. Non-limiting methods include, e.g., segment-to-segment comparison, see, e.g., Burkhard Morgenstern et al., Multiple DNA
and Protein Sequence Alignment Based On Segment-To-Segment Comparison, 93(22) Proc. Natl. Acad. Sci.
U.S.A. 12098-12103 (1996); T-Coffee, see, e.g., Cedric Notredame et al., T-Coffee: A Novel Algorithm for Multiple Sequence Alignment, 302(1) J. Mol. Biol. 205-217 (2000); MUSCLE, see, e.g., Robert C. Edgar, MUSCLE: Multiple Sequence Alignment With High Score Accuracy and High Throughput, 32(5) Nucleic Acids Res. 1792-1797 (2004); and DIALIGN-T, see, e.g., Amarendran R Subramanian et al., DIALIGN-T: An Improved Algorithm for Segment-Based Multiple Sequence Alignment, 6(1) BMC
Bioinformatics 66 (2005).
[032] Thus in an embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin as the Clostridial toxin active ingredient. In aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a BoNT/A, a BoNT/B, a BoNT/Ci, a BoNT/D, a BoNT/E, a BoNT/F, a BoNT/G, a TeNT, a BaNT, or a BuNT. In another embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin variant as the Clostridial toxin active ingredient. In aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises naturally-occurring Clostridial toxin variant or a non-naturally-occurring Clostridial toxin variant. In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a BoNT/A variant, a BoNT/B variant, a BoNT/Ci variant, a BoNT/D variant, a BoNT/E
variant, a BoNT/F variant, a BoNT/G variant, a TeNT variant, a BaNT variant, or a BuNT variant, where the variant is either a naturally-occurring variant or a non-naturally-occurring variant.
[033] In an aspect of this embodiment, a hydrophic amino acid at one particular position in the polypeptide chain can be substituted with another hydrophic amino acid. Examples of hydrophic amino acids include, e.g., C, F, I, L, M, V and W. In another aspect of this embodiment, an aliphatic amino acid at one particular position in the polypeptide chain can be substituted with another aliphatic amino acid. Examples of aromatic amino acids include, e.g., A, I, L, P, and V. In yet another aspect of this embodiment, an aliphatic amino acid at one particular position in the polypeptide chain can be substituted with another aromatic amino acid.
Examples of aromatic amino acids indude, e.g., F, H, Wand Y. In still another aspect of this embodiment, a stacking amino acid at one particular position in the polypeptide chain can be substituted with another stacking amino acid. Examples of stacking amino acids include, e.g., F, H, Wand Y. In a further aspect of this embodiment, a polar amino acid at one particular position in the polypeptide chain can be substituted with another polar amino acid. Examples of polar amino acids include, e.g., D, E, K, N, Q, and R. In a further aspect of this embodiment, a less polar or indifferent amino acid at one particular position in the polypeptide chain can be substituted with another less polar or indifferent amino acid.
Examples of less polar or indifferent amino acids include, e.g., A, H, G, P, S, T, and Y. In a yet further aspect of this embodiment, a positive charged amino acid at one particular position in the polypeptide chain can be substituted with another positive charged amino acid. Examples of positive charged amino acids include, e.g., K, R, and H. In a still further aspect of this embodiment, a negative charged amino acid at one particular position in the polypeptide chain can be substituted with another negative charged amino acid. Examples of negative charged amino acids include, e.g., D and E. In another aspect of this embodiment, a small amino acid at one particular position in the polypeptide chain can be substituted with another small amino acid. Examples of small amino acids include, e.g., A, D, G, N, P, S, and T. In yet another aspect of this embodiment, a C-beta branching amino acid at one particular position in the polypeptide chain can be substituted with another C-beta branching amino acid. Examples of C-beta branching amino acids include, e.g., I, T and V.
[034] Aspects of the present pharmaceutical compositions provide, in part, a Clostridial toxin complex as a Clostridial toxin active ingredient. As used herein, the term "Clostridial toxin complex" refers to a complex comprising a Clostridial toxin and associated NAPs, such as, e.g., a Botulinum toxin complex, a Tetanus toxin complex, a Baratii toxin complex, and a Butyricum toxin complex. Non-limiting examples of Clostridial toxin complexes include those produced by a Clostridium botulinum, such as, e.g., a 900-kDa BoNT/A complex, a 500-kDa BoNT/A complex, a 300-kDa BoNT/A complex, a 500-kDa BoNT/B complex, a 500-kDa BoNT/C1 complex, a 500-kDa BoNT/D complex, a 300-kDa BoNT/D complex, a 300-kDa BoNT/E
complex, and a 300-kDa BoNT/F complex. Clostridial toxin complexes can be purified using the methods described in Schantz, supra, (1992); Hui Xiang et al., Animal Product Free System and Process for Purifying a Botulinum Toxin, U.S. Patent 7,354,740.
Clostridial toxin complexes can be obtained from, e.g., List Biological Laboratories, Inc.
(Campbell, California), the Centre for Applied Microbiology and Research (Porton Down, U.K), Wako (Osaka, Japan), and Sigma Chemicals (St Louis, Missouri).
[035] For example, high quality crystalline BoNT/A complex can be produced from the Hall A strain of Clostridium botulinum with characteristics of X 107 U/mg, an A260/A278 of less than 0.60 and a distinct pattern of banding on gel electrophoresis using the Schantz process. See Schantz, supra, (1992). Generally, the BoNT/A complex can be isolated and purified from an anaerobic fermentation by cultivating Clostridium botulinum type A in a suitable medium. Raw toxin can be harvested by precipitation with sulfuric acid and concentrated by ultramicrofiltration. Purification can be carried out by dissolving the acid precipitate in calcium chloride. The toxin can then be precipitated with cold ethanol. The precipitate can be dissolved in sodium phosphate buffer and centrifuged. Upon drying there can then be obtained approximately 900 kD crystalline BoNT/A complex with a specific potency of 3 X 107 LD50 U/mg or greater.
[036] Thus in an embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin complex as the Clostridial toxin active ingredient. In aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a BoNT/A complex, a BoNT/B complex, a BoNT/C, complex, a BoNT/D complex, a BoNT/E complex, a BoNT/F complex, a BoNT/G complex, a TeNT
complex, a BaNT
complex, or a BuNT complex. In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a 900-kDa BoNT/A complex, a 500-kDa BoNT/A complex, a 300-kDa BoNT/A
complex, a 500-kDa BoNT/B complex, a 500-kDa B0NT/C1 complex, a 500-kDa BoNT/D
complex, a 300-kDa BoNT/D complex, a 300-kDa BoNT/E complex, or a 300-kDa BoNT/F complex.
[037] Aspects of the present pharmaceutical compositions provide, in part, a modified Clostridial toxin as a Clostridial toxin active ingredient. As used herein, the term "modified Clostridial toxin" refers to any Clostridial toxin modified in some manner to provide a property or characteristic not present in the unmodified Clostridial toxin, but can still execute the overall cellular mechanism whereby a Clostridial toxin intoxicates a cell, including, e.g., the binding of a Clostridial toxin to a low or high affinity Clostridial toxin receptor, the internalization of the toxin/receptor complex, the translocation of the Clostridial toxin light chain into the cytoplasm and the enzymatic modification of a Clostridial toxin substrate. Non-limiting examples of Clostridial toxin variants are described in Steward, L.E. et al., Post-Translational Modifications and Clostridial Neurotoxins, U.S. Patent 7,223,577; Wei-Jen Lin et al., Neurotoxins with Enhanced Target Specificity, U.S.
Patent 7,273,722; Lance E. Steward et al., Clostridia! Neurotoxin Compositions and Modified Clostridial Toxin Neurotoxins, U.S. Patent Publication 2004/0220386; Steward, L.E. et al., Clostridial Toxin Activatable Clostridia! Toxins, U.S. Patent Publication 2007/0166332; Lance E. Steward et al., Modified Clostridia! Toxins With Enhanced Targeting Capabilities For Endogenous Clostridial Toxin Receptor Systems, U.S. Patent Publication 2008/0096248; Steward, L.E. et al., Modified Clostridia! Toxins with Enhanced Translocation Capability and Enhanced Targeting Activity, U.S. Patent Application No.
11/776,043; Steward, L.E. et al., Modified Clostridial Toxins with Enhanced Translocation Capabilities and Altered Targeting Activity For Clostridial Toxin Target Cells, U.S. Patent Application No. 11/776,052.
Steward, L.E. et al., Degradable Clostridia! Toxins, U.S. Patent Application No.
12/192,905.
[038] Thus in an embodiment, a Clostridial toxin pharmaceutical composition comprises a modified Clostridial toxin as the Clostridial toxin active ingredient. In aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a modified BoNT/A, a modified BoNT/B, a modified B0NT/C1, a modified BoNT/D, a modified BoNT/E, a modified BoNT/F, a modified BoNT/G, a modified TeNT, a modified BaNT, or a modified BuNT.
[039] In another embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, a Clostridial toxin binding domain and an additional di-I eucine motif.
[040] Aspects of the present pharmaceutical compositions provide, in part, a re-targeted Clostridial toxin as a Clostridial toxin active ingredient. As used herein, the term "re-targeted Clostridial toxin" refers to a Clostridial toxin modified to selectively bind to a non-Clostridial toxin receptor present on a non-Clostridial toxin target cell, but otherwise execute the remaining intoxication steps of a Clostridial toxin, such as, e.g., the internalization of the toxin/receptor complex, the translocation of the Clostridial toxin light chain into the cytoplasm and the enzymatic modification of a Clostridial toxin substrate. A
retargeted Clostridial toxin can intoxicate wither a neuronal cell or a non-neuronal cell, depending on the modification made to the Clostridial toxin. A re-targeted Clostridial toxin can be a re-targeted Botulinum toxin, re-targeted Tetanus toxin, re-targeted Baratii toxin, and a re-targeted Butyricum toxin. Non-limiting examples of a re-targeted Clostridial toxin are described in, e.g., Keith A. Foster et al., Clostridia! Toxin Derivatives Able To Modify Peripheral Sensory Afferent Functions, U.S. Patent 5,989,545; Clifford C. Shone et al., Recombinant Toxin Fragments, U.S. Patent 6,461,617; Conrad P. Quinn et al., Methods and Compounds for the Treatment of Mucus Hypersecretion, U.S. Patent 6,632,440; Lance E. Steward et al., Methods And Compositions For The Treatment Of Pancreatitis, U.S. Patent 6,843,998; J. Oliver Dolly et al., Activatable Recombinant Neurotoxins, U.S. Patent 7,132,259; Stephan Donovan, Clostridial Toxin Derivatives and Methods For Treating Pain, U.S.
Patent Publication 2002/0037833; Keith A. Foster et al., Inhibition of Secretion from Non-neural Cells, U.S.
Patent Publication 2003/0180289; Lance E. Steward et al., Multivalent Clostridial Toxin Derivatives and Methods of Their Use, U.S. Patent Publication 2006/0211619; Keith A. Foster et al., Non-Cytotoxic Protein Conjugates, U.S. Patent Publication 2008/0187960; Steward, L.E. et al., Modified Clostridia! Toxins with Enhanced Translocation Capabilities and Altered Targeting Activity For Non-Clostridial Toxin Target Cells, U.S. Patent Application No. 11/776,075; Keith A. Foster et al., Re-targeted Toxin Conjugates, U.S. Patent Application No. 11/792,210
[041] Thus in an embodiment, a Clostridial toxin pharmaceutical composition comprises a re-targeted Clostridial toxin as the Clostridial toxin active ingredient. In aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a re-targeted BoNT/A, a re-targeted BoNT/B, a re-targeted BoNT/Ci, a re-targeted BoNT/D, a re-targeted BoNT/E, a re-targeted BoNT/F, a re-targeted BoNT/G, a re-targeted TeNT, a re-targeted BaNT, or a re-targeted BuNT. In another aspect of this embodiment, a Clostridial toxin pharmaceutical composition comprises a re-targeted Clostridial toxin comprises an opiod targeting moiety, such as, e.g., an enkephalin, an endomorphin, an endorphin, a dynorphin, a nociceptin or a hemorphin. In yet another aspect of this embodiment, a Clostridial toxin pharmaceutical composition comprises a re-targeted Clostridial toxin comprises a tachykinin targeting moiety, such as, e.g., a Substance P, a neuropeptide K
(NPK), a neuropeptide gamma (NP gamma), a neurokinin A (NKA; Substance K, neurokinin alpha, neuromedin L), a neurokinin B (NKB), a hemokinin or a endokinin. In still another aspect of this embodiment, a Clostridial toxin pharmaceutical composition comprises a re-targeted Clostridial toxin comprises a melanocortin targeting moiety, such as, e.g., a melanocyte stimulating hormone, adrenocorticotropin, or a lipotropin. In still another aspect of this embodiment, a Clostridial toxin pharmaceutical composition comprises a re-targeted Clostridial toxin comprises a galanin targeting moiety, such as, e.g., a galanin or a galanin message-associated peptide. In a further aspect of this embodiment, a Clostridial toxin pharmaceutical composition comprises a re-targeted Clostridial toxin comprises a granin targeting moiety, such as, e.g., a Chromogranin A, a Chromogranin B, or a a Chromogranin C. In another aspect of this embodiment, a Clostridial toxin pharmaceutical composition comprises a re-targeted Clostridial toxin comprises a Neuropeptide Y related peptide targeting moiety, such as, e.g., a Neuropeptide Y, a Peptide YY, Pancreatic peptide or a Pancreatic icosapeptide. In yet another aspect of this embodiment, a Clostridial toxin pharmaceutical composition comprises a re-targeted Clostridial toxin comprises a neurohormone targeting moiety, such as, e.g., a corticotropin-releasing hormone, a parathyroid hormone, a thyrotropin-releasing hormone, or a somatostatin. In still another aspect of this embodiment, a Clostridial toxin pharmaceutical composition comprises a re-targeted Clostridial toxin comprises a neuroregulatory cytokine targeting moiety, such as, e.g., a ciliary neurotrophic factor, a glycophorin-A, a leukemia inhibitory factor, a cholinergic differentiation factor, an interleukin, an onostatin M, a cardiotrophin-1, a cardiotrophin-like cytokine, or a neuroleukin. In a further aspect of this embodiment, a Clostridial toxin pharmaceutical composition comprises a re-targeted Clostridial toxin comprises a kinin peptide targeting moiety, such as, e.g., a bradykinin, a kallidin, a desArg9 bradykinin, or a desArg 10 bradykinin. In another aspect of this embodiment, a Clostridial toxin pharmaceutical composition comprises a re-targeted Clostridial toxin comprises a fibroblast growth factor targeting moiety, a nerve growth factor targeting moiety, an insulin growth factor targeting moiety, an epidermal growth factor targeting moiety, a vascular endothelial growth factor targeting moiety, a brain derived neurotrophic factor targeting moiety, a growth derived neurotrophic factor targeting moiety, a neurotrophin targeting moiety, such as, e.g., a neurotrophin-3, a neurotrophin-4/5, a head activator peptide targeting moiety, a neurturin targeting moiety, a persephrin targeting moiety, an artemin targeting moiety, a transformation growth factor [3 targeting moiety, such as, e.g., a TG931, a TGF[32, a TGF[33 or a TG934, a bone morphogenic protein targeting moiety, such as, ie.g., a BMP2, a BMP3, a BMP4, a BMP5, a BMP6, a BMP7, a BMP8 or a BMP10, a growth differentiation factor targeting moiety, such as, e.g., a GDF1, a GDF2, a GDF3, a GDF5, a GDF6, a GDF7, a GDF8, a GDF10, a GDF11 or a GDF15, or an activin targeting moiety, such as, e.g., an activin A, an activin B, an activin C, an activin E or an inhibin A. In another aspect of this embodiment, a Clostridial toxin pharmaceutical composition comprises a re-targeted Clostridial toxin comprises a glucagon like hormone targeting moiety, such as, e.g., a secretin, a glucagon-like peptide, like a GLP-1 and a GLP-2, a pituitary adenylate cyclase activating peptide targeting moiety, a growth hormone-releasing hormone targeting moiety, vasoactive intestinal peptide targeting moiety like a VIP1 or a VIP2, a gastric inhibitory polypeptide targeting moiety, a calcitonin-related peptidesvisceral gut peptide targeting moiety like a gastrin, a gastrin-releasing peptide or a cholecystokinin, or a PAR peptide targeting moiety like a PAR1 peptide, a PAR2 peptide, a PAR3 peptide or a PAR4 peptide.
[042] In another embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a non-Clostridial toxin binding domain. In aspects of this embodiment, the single-chain protein comprises a linear amino-to-carboxyl order of 1) the Clostridial enzymatic domain, the Clostridial translocation domain and the non-Clostridial binding domain; 2) the Clostridial enzymatic domain, the non-Clostridial binding domain and the Clostridial translocation domain;
3) the non-Clostridial binding domain, the Clostridial toxin translocation domain, and the Clostridia! toxin enzymatic domain; 4) the non-Clostridial binding domain, the Clostridial toxin enzymatic domain, and the Clostridial toxin translocation domain; 5) the Clostridial toxin translocation domain, the Clostridial toxin enzymatic domain and the non-Clostridial binding domain; or 6) the Clostridial toxin translocation domain, the non-Clostridial binding domain and the Clostridial toxin enzymatic domain.
[043] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and an opioid binding domain. In further aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises 1) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and an enkephalin binding domain; 2) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a bovine adrenomedullary-22 (BAM22) peptide binding domain; 3) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and an endomorphin binding domain; 4) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and an endorphin binding domain; 5) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a dynorphin binding domain; 6) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a nociceptin binding domain; 7) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a hemorphin binding domain; or 8) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a rimorphin binding domain.
[044] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a melanocortin peptide binding domain. In further aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises 1) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a melanocyte stimulating hormone binding domain; 2) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and an adrenocorticotropin binding domain; or 3) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a lipotropin binding domain.
[045] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a galanin peptide binding domain. In further aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises 1) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a galanin binding domain; or 2) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a galanin message-associated peptide (GMAP) binding domain.
[046] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a granin peptide binding domain. In further aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises 1) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a chromogranin A binding domain; 2) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a chromogranin B binding domain; or 3) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a chromogranin C binding domain.
[047] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a tachykinin peptide binding domain. In further aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises 1) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a Substance P binding domain; 2) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a neuropeptide K binding domain; 3) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a neuropeptide gamma binding domain; 4) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a neurokinin A binding domain; 5) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a hemokinin binding domain; or 6) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and an endokinin binding domain.
[048] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a Neuropeptide Y related peptide binding domain. In further aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises 1) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a neuropeptide Y (NPY) binding domain; 2) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a Peptide YY (PYY) binding domain; 3) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a Pancreatic peptide (PP) binding domain; or 4) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a Pancreatic icosapeptide (PIP) binding domain.
[049] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a neurohormone peptide binding domain. In further aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises 1) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a corticotropin-releasing hormone (CCRH) binding domain; 2) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a parathyroid hormone (PTH) binding domain; 3) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a thyrotropin-releasing hormone (TRH) binding domain;
or 4) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a somatostatin binding domain.
[050] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a cytokine peptide binding domain. In further aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises 1) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a ciliary neurotrophic factor (CNTF) binding domain; 2) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a glycophorin-A (GPA) binding domain; 3) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a leukemia inhibitory factor (LIF) binding domain;
4) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and an interleukin (IL) binding domain; 5) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and an onostatin M
binding domain; 6) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a cardiotrophin-1 (CT-1) binding domain; 7) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a cardiotrophin-like cytokine (CLC) binding domain; 8) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a neuroleukin binding domain.
[051] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a kinin peptide binding domain. In further aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises 1) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a bradykinin binding domain;
2) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a kallidin binding domain;
3) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a desArg9 bradykinin binding domain; or 4) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a desArg 10 bradykinin binding domain.
[052] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a Fibroblast growth factor (FGF) peptide binding domain. In further aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises 1) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a FGF-1 binding domain; 2) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a FGF-2 binding domain; 3) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a FGF-4 binding domain; 4) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a FGF-8 binding domain; 5) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a FGF-9 binding domain; 6) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a FGF-17 binding domain; or 4) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a FGF-18 binding domain.
[053] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a neurotrophin peptide binding domain. In further aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises 1) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a nerve growth factor (NGF) binding domain; 2) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a brain derived neurotrophic factor (BDNF) binding domain; 3) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a neurotrophin-3 (NT-3) binding domain; 4) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a neurotrophin-4/5 (NT-4/5) binding domain; or 5) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a head activator peptide (HA) binding domain.
[054] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a tumor necrosis factor (TNF) peptide binding domain.
[055] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a Glial derived growth factor (GDNF) peptide binding domain. In further aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises 1) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a neurturin binding domain; 2) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a persephrin binding domain; or 3) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and an artemin binding domain.
[056] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a Transformation growth factor 13 (TG93) peptide binding domain. In further aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises 1) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a TGF131 binding domain; 2) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a TGF132 binding domain; 3) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a TGF133 binding domain; or 4) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a TGF134 binding domain.
[057] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a Bone morphogenetic protein 13 (BMP) peptide binding domain. In further aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises 1) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a BMP2 binding domain; 2) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a BMP3 binding domain; 3) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a BMP4 binding domain; 4) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a BMP5 binding domain; 5) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a BMP6 binding domain; 6) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a BMP7 binding domain; 7) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a BMP8 binding domain; or 8) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a BMP10 binding domain.
[058] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a Growth and differentiation factor 13 (GDF) peptide binding domain. In further aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises 1) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a GDF1 binding domain; 2) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a GDF2 binding domain; 3) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a GDF3 binding domain; 4) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a GDF5 binding domain; 5) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a GDF6 binding domain; 6) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a GDF7 binding domain; 7) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a GDF8 binding domain; 8) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a GDF10 binding domain; 9) a Clostridial toxin enzymatic domain, a Clostridia!

toxin translocation domain, and a GDF11 binding domain; or 10) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a GDF 15 binding domain.
[059] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and an activin peptide binding domain. In further aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises 1) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and an activin A binding domain;
2) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and an activin B binding domain; 3) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and an activin C
binding domain; 4) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and an activin E binding domain; or 5) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and an inhibin A binding domain.
[060] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a Vascular endothelial growth factor (VEGF) peptide binding domain.
[061] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and an insulin growth factor (IGF) peptide binding domain. In further aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises 1) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and an IGF-1 binding domain; or 2) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and an IGF-2 binding domain.
[062] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and an Epidermal growth factor (EGF) peptide binding domain.
[063] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a Glucagon like hormone peptide binding domain. In further aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises 1) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a secretin binding domain; or 2) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a glucagon-like peptide binding domain.
[064] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a Pituitary adenylate cyclase activating peptide (PACAP) peptide binding domain.
[065] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a Growth hormone-releasing hormone (GHRH) peptide binding domain.
[066] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a Growth hormone-releasing hormone (GHRH) peptide binding domain.
[067] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a Vasoactive intestinal peptide (VIP) peptide binding domain. In further aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises 1) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a VIP1 binding domain; or 2) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a VIP2 binding domain.
[068] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a Gastric inhibitory polypeptide (GIP) peptide binding domain.
[069] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a Calcitonin-related peptidesvisceral gut peptide binding domain. In further aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises 1) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a gastrin binding domain; 2) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a gastrin-releasing peptide binding domain; or 3) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a cholecystokinin (CCK) binding domain.
[070] In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a protease activated receptor (PAR) peptide binding domain. In further aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises 1) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a PAR1 binding domain; 2) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a PAR2 binding domain; 3) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a PAR3 binding domain; or 4) a Clostridial toxin enzymatic domain, a Clostridial toxin translocation domain, and a PAR4 binding domain.
[071] Aspects of the present pharmaceutical compositions provide, in part, a pharmacologically acceptable excipient. As used herein, the term "pharmacologically acceptable excipient"
is synonymous with "pharmacological excipient" or "excipient" and refers to any excipient that has substantially no long term or permanent detrimental effect when administered to mammal and encompasses compounds such as, e.g., stabilizing agent, a bulking agent, a cryo-protectant, a lyo-protectant, an additive, a vehicle, a carrier, a diluent, or an auxiliary. An excipient generally is mixed with an active ingredient, or permitted to dilute or enclose the active ingredient and can be a solid, semi-solid, or liquid agent.
It is also envisioned that a pharmaceutical composition comprising a Clostridial toxin active ingredient can include one or more pharmaceutically acceptable excipients that facilitate processing of an active ingredient into pharmaceutically acceptable compositions. Insofar as any pharmacologically acceptable excipient is not incompatible with the Clostridial toxin active ingredient, its use in pharmaceutically acceptable compositions is contemplated. Non-limiting examples of pharmacologically acceptable excipients can be found in, e.g., Pharmaceutical Dosage Forms and Drug Delivery Systems (Howard C. Ansel et al., eds., Lippincott Williams & Wilkins Publishers, 7th ed. 1999); Remington; The Science and Practice of Pharmacy (Alfonso R. Gennaro ed., Lippincott, Williams &
Wilkins, 20' ed. 2000); Goodman & Gilman's The Pharmacological Basis of Therapeutics (Joel G. Hardman et al., eds., McGraw-Hill Professional, 10th ed. 2001); and Handbook of Pharmaceutical Excipients (Raymond C. Rowe et at., APhA Publications, 4th edition 2003) .
[072] Aspects of the present pharmaceutical compositions provide, in part, an effective amount." As used herein, the term "effective amount," when used in reference to the amount of an excipient or specific combination of excipients added to a Clostridial toxin composition, refers to the amount of each excipient that is necessary to achieve the desired initial recovered potency of a Clostridial toxin active ingredient. In aspects of this embodiment, an effective amount of an excipient or combination of excipients results in an initial recovered potency of, e.g., at least 10%, at least 20%, at least 30%, at least 40%, at least 50%, at least 60%, at least 70%, at least 80%, at least 90% or at least 100%. In other aspects of this embodiment, a therapeutically effective concentration of a Clostridial toxin active ingredient reduces a symptom associated with the aliment being treated by, e.g., at most 10%, at most 20%,at most 30%, at most 40%, at most 50%, at most 60%, at most 70%, at most 80%, at most 90% or at most 100%.
[073] In yet other aspects of this embodiment, an effective amount of an excipient is, e.g., at least 0.1 mg, at least 0.125 mg, at least 0.2 mg, at least 0.25 mg, at least 0.3 mg, at least 0.3125 mg, at least 0.4 mg, at least 0.5 mg, at least 0.6 mg, at least 0.625 mg, at least 0.7 mg, at least 0.8 mg, or at least 0.9 mg. In still aspects of this embodiment, an effective amount of an excipient is, e.g., at least 1.0 mg, at least 2.0 mg, at least 3.0 mg, at least 4.0 mg, at least 5.0 mg, at least 6.0 mg, at least 7.0 mg, at least 8.0 mg, or at least 9.0 mg. In further aspects of this embodiment, an effective amount of an excipient is, e.g., at least 10 mg, at least 20 mg, at least 30 mg, at least 40 mg, at least 50 mg, at least 60 mg, at least 70 mg, at least 80 mg, at least 90 mg, or at least 100 mg.
[074] In yet other aspects of this embodiment, an effective amount of an excipient is, e.g., at most 0.1 mg, at most 0.125 mg, at most 0.2 mg, at most 0.25 mg, at most 0.3 mg, at most 0.3125 mg, at most 0.4 mg, at most 0.5 mg, at most 0.6 mg, at most 0.625 mg, at most 0.7 mg, at most 0.8 mg, or at most 0.9 mg. In still aspects of this embodiment, an effective amount of an excipient is, e.g., at most 1.0 mg, at most 2.0 mg, at most 3.0 mg, at most 4.0 mg, at most 5.0 mg, at most 6.0 mg, at most 7.0 mg, at most 8.0 mg, or at most 9.0 mg. In further aspects of this embodiment, an effective amount of an excipient is, e.g., at most 10 mg, at most 20 mg, at most 30 mg, at most 40 mg, at most 50 mg, at most 60 mg, at most 70 mg, at most 80 mg, at most 90 mg, or at most 100 mg.
[075] In yet other aspects of this embodiment, an effective amount of an excipient is, e.g., from about 0.1 mg to about 100 mg, from about 0.1 mg to about 50 mg, from about 0.1 mg to about 10 mg, from about 0.25 mg to about 100 mg, from about 0.25 mg to about 50 mg, from about 0.25 mg to about 10 mg, from about 0.5 mg to about 100 mg, from about 0.5 mg to about 50 mg, from about 0.5 mg to about 10 mg, from about 0.75 mg to about 100 mg, from about 0.75 mg to about 50 mg, from about 0.75 mg to about 10 mg, from about 1.0 mg to about 100 mg, from about 1.0 mg to about 50 mg, or from about 1.0 mg to about 10 mg.
[076] In yet other aspects of this embodiment, an effective amount of an excipient is, e.g., at least 0.001 %, at least 0.002%, at least 0.003%, at least 0.004%, at least 0.005%, at least 0.006%, at least 0.007%, at least 0.008%, or at least 0.009%. In still other aspects of this embodiment, an effective amount of an excipient is, e.g., at least 0.01 %, at least 0.02%, at least 0.03%, at least 0.04%, at least 0.05%, at least 0.06%, at least 0.07%, at least 0.08%, or at least 0.09%. In still aspects of this embodiment, an effective amount of an excipient is, e.g., at least 0.1%, at least 0.2%, at least 0.3%, at least 0.4%, at least 0.5%, at least 0.6%, at least 0.7%, at least 0.8%, or at least 0.9%. In further aspects of this embodiment, an effective amount of an excipient is, e.g., at least 1%, at least 2%, at least 3%, at least 4%, at least 5%, at least 6%, at least 7%, at least 8%, or at least 9%.
[077] In yet other aspects of this embodiment, an effective amount of an excipient is, e.g., at most 0.001 %, at most 0.002%, at most 0.003%, at most 0.004%, at most 0.005%, at most 0.006%, at most 0.007%, at most 0.008%, or at most 0.009%. In still other aspects of this embodiment, an effective amount of an excipient is, e.g., at most 0.01 %, at most 0.02%, at most 0.03%, at most 0.04%, at most 0.05%, at most 0.06%, at most 0.07%, at most 0.08%, or at most 0.09%. In still aspects of this embodiment, an effective amount of an excipient is, e.g., at most 0.1%, at most 0.2%, at most 0.3%, at most 0.4%, at most 0.5%, at most 0.6%, at most 0.7%, at most 0.8%, or at most 0.9%. In further aspects of this embodiment, an effective amount of an excipient is, e.g., at most 1%, at most 2%, at most 3%, at most 4%, at most 5%, at most 6%, at most 7%, at most 8%, or at most 9%.
[078] In still other aspects of this embodiment, an effective amount of an excipient is, e.g., from about 0.001% to about 0.01%, from about 0.001% to about 0.1%, from about 0.001% to about 1%, from about 0.001% to about 10%, from about 0.01% to about 0.1%, from about 0.01% to about 1%, from about 0.01% to about 10%, from about 0.1% to about 1%, or from about 0.1% to about 10%.
[079] Aspects of the present pharmaceutical compositions provide, in part, non-protein excipient. As used herein, the term "non-protein excipient" refers to any excipient that is not a polypeptide comprising at least fifteen amino acids. It is envisioned that any non-protein excipient is useful in formulating a Clostridial toxin pharmaceutical compositions disclosed in the present specification, with the proviso that a therapeutically effective amount of the Clostridial toxin active ingredient is recovered using this non-protein excipient.
[080] Aspects of the present pharmaceutical compositions provide, in part, a sugar. As used herein, the term "sugar" refers to a compound comprising one to 10 monosaccharide units, e.g., a monosaccharide, a disaccharide, a trisaccharide, and an oligosaccharide comprising four to ten monosaccharide units. It is envisioned that any sugar is useful in formulating a Clostridial toxin pharmaceutical compositions disclosed in the present specification, with the proviso that a therapeutically effective amount of the Clostridial toxin active ingredient is recovered using this sugar. Monosaccharides are polyhydroxy aldehydes or polyhydroxy ketones with three or more carbon atoms, including aldoses, dialdoses, aldoketoses, ketoses and diketoses, as well as cydic forms, deoxy sugars and amino sugars, and their derivatives, provided that the parent monosaccharide has a (potential) carbonyl group. Monosacchrides include trioses, like glyceraldehyde and dihydroxyacetone; tetroses, like erythrose, erythrulose and threose; pentoses, like arabinose, lyxose, ribose, ribulose, xylose, xylulose; hexoses, like allose, altrose, fructose, fucose,galactose, glucose, gulose, idose, mannose, psicose, rhamnose, sorbose, tagatose, talose and trehalose; heptoses, like sedoheptulose and mannoheptulose; octooses, like octulose and 2-keto-3-deoxy-manno-octonate;
nonoses like sialose; and decose. Oligosaccharides are compounds in which at least two monosaccharide units are joined by glycosidic linkages. According to the number of units, they are called disaccharides, trisaccharides, tetrasaccharides, pentasaccharides, hexoaccharides, heptoaccharides, octoaccharides, nonoaccharides, decoaccharides, etc. An oligosaccharide can be unbranched, branched or cyclic.
Common disaccharides include, without limitation, sucrose, lactose, maltose, trehalose, cellobiose, gentiobiose, kojibiose, laminaribiose, mannobiose, melibiose, nigerose, rutinose, and xylobiose.
Common trisaccharides include, without limitation, raffinose, acarbose, maltotriose, and melezitose. Other non-limiting examples of specific uses of sugar excipients can be found in, e.g., ANSEL, SUPRA, (1999); GENNARO, SUPRA, (2000); HARDMAN, SUPRA, (2001); AND ROWE, SUPRA, (2003)
[081] Thus in an embodiment, a Clostridial toxin pharmaceutical composition comprises a sugar. In aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a monosaccharide. In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a disaccharide, a trisaccharide, a tetrasaccharide, a pentasaccharide, a hexoaccharide, a heptoaccharide, an octoaccharide, a nonoaccharide, or a decoaccharide. In yet other aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises an oligosaccharide comprising two to ten monosaccharide units.
[082] It is envisioned that any amount of sugar is useful in formulating a Clostridial toxin pharmaceutical compositions disclosed in the present specification, with the proviso that a therapeutically effective amount of the Clostridial toxin active ingredient is recovered using this sugar amount.
In aspects of this embodiment, the amount of sugar added to the formulation is about 0.1% (w/v), about 0.5%
(w/v), about 1.0% (w/v), about 1.5% (w/v), about 2.0% (w/v), about 2.5% (w/v), about 3.0% (w/v), about 3.5%
(w/v), about 4.0% (w/v), about 4.5% (w/v), about 5.0% (w/v), about 5.5% (w/v), about 6.0% (w/v), about 6.5%
(w/v), about 7.0% (w/v), about 7.5% (w/v), about 8.0% (w/v), about 8.5% (w/v), about 9.0% (w/v), about 9.5%
(w/v), about 10% (w/v), about 15% (w/v), about 20% (w/v), about 25% (w/v), about 30% (w/v), or about 35%
(w/v). In other aspects of this embodiment, the amount of sugar added to the formulation is at least 0.1%
(w/v), at least 0.5% (w/v), at least 1.0% (w/v), at least 1.5% (w/v), at least 2.0% (w/v), at least 2.5% (w/v), at least 3.0% (w/v), at least 3.5%
(w/v), at least 4.0% (w/v), at least 4.5% (w/v), at least 5.0% (w/v), at least 5.5% (w/v), at least 6.0% (w/v), at least 6.5% (w/v), at least 7.0% (w/v), at least 7.5% (w/v), at least 8.0%
(w/v), at least 8.5% (w/v), at least 9.0%

(w/v), at least 9.5% (w/v), at least 10% (w/v), at least 15% (w/v), at least 20% (w/v), at least 25% (w/v), at least 30% (w/v), or at least 35% (w/v). In yet other aspects of this embodiment, the amount of sugar added to the formulation is at most 0.1% (w/v), at most 0.5% (w/v), at most 1.0% (w/v), at most 1.5% (w/v), at most 2.0% (w/v), at most 2.5% (w/v), at most 3.0% (w/v), at most 3.5% (w/v), at most 4.0% (w/v), at most 4.5%
(w/v), at most 5.0% (w/v), at most 5.5% (w/v), at most 6.0% (w/v), at most 6.5% (w/v), at most 7.0% (w/v), at most 7.5% (w/v), at most 8.0% (w/v), at most 8.5% (w/v), at most 9.0% (w/v), at most 9.5% (w/v), at most 10%
(w/v), at most 15% (w/v), at most 20% (w/v), at most 25% (w/v), at most 30%
(w/v), or at most 35% (w/v).
[083] Aspects of the present pharmaceutical compositions provide, in part, a polyol. As used herein, the term "polyol" is synonymous with "sugar alcohol," "polyhydric alcohol," and "polyalcohor and refers to a sugar derivative having an alcohol group (CH2OH) instead of the aldehyde group (CHO), such as, e.g., mannitol from mannose, xylitol from xylose, and lactitol from lactulose. It is envisioned that any polyol is useful in formulating a Clostridial toxin pharmaceutical compositions disclosed in the present specification, with the proviso that a therapeutically effective amount of the Clostridial toxin active ingredient is recovered using this polyol. Non-limiting examples of polyols include, glycol, glycerol, arabitol, erythritol, xylitol, maltitol, sorbitol (gluctiol), mannitol, inositol, lactitol, galactitol (iditol), isomalt. Other non-limiting examples of sugar excipients can be found in, e.g., Ansel, supra, (1999); Gennaro, supra, (2000); Hardman, supra, (2001); and Rowe, supra, (2003).
[084] Thus in an embodiment, a Clostridial toxin pharmaceutical composition comprises a polyol. In aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises glycol, glycerol, arabitol, erythritol, xylitol, maltitol, sorbitol (gluctiol), mannitol, inositol, lactitol, galactitol (iditol), or isomalt.
[085] It is envisioned that any amount of polyol is useful in formulating a Clostridial toxin pharmaceutical compositions disclosed in the present specification, with the proviso that a therapeutically effective amount of the Clostridial toxin active ingredient is recovered using this polyol amount.
In aspects of this embodiment, the amount of polyol added to the formulation is about 0.1% (w/v), about 0.5%
(w/v), about 1.0% (w/v), about 1.5% (w/v), about 2.0% (w/v), about 2.5% (w/v), about 3.0% (w/v), about 3.5%
(w/v), about 4.0% (w/v), about 4.5% (w/v), about 5.0% (w/v), about 5.5% (w/v), about 6.0% (w/v), about 6.5%
(w/v), about 7.0% (w/v), about 7.5% (w/v), about 8.0% (w/v), about 8.5% (w/v), about 9.0% (w/v), about 9.5%
(w/v), about 10% (w/v), about 15% (w/v), about 20% (w/v), about 25% (w/v), about 30% (w/v), or about 35%
(w/v). In other aspects of this embodiment, the amount of polyol added to the formulation is at least 0.1%
(w/v), at least 0.5% (w/v), at least 1.0% (w/v), at least 1.5% (w/v), at least 2.0% (w/v), at least 2.5% (w/v), at least 3.0% (w/v), at least 3.5%
(w/v), at least 4.0% (w/v), at least 4.5% (w/v), at least 5.0% (w/v), at least 5.5% (w/v), at least 6.0% (w/v), at least 6.5% (w/v), at least 7.0% (w/v), at least 7.5% (w/v), at least 8.0%
(w/v), at least 8.5% (w/v), at least 9.0%
(w/v), at least 9.5% (w/v), at least 10% (w/v), at least 15% (w/v), at least 20% (w/v), at least 25% (w/v), at least 30% (w/v), or at least 35% (w/v). In yet other aspects of this embodiment, the amount of polyol added to the formulation is at most 0.1% (w/v), at most 0.5% (w/v), at most 1.0% (w/v), at most 1.5% (w/v), at most 2.0% (w/v), at most 2.5% (w/v), at most 3.0% (w/v), at most 3.5% (w/v), at most 4.0% (w/v), at most 4.5%
(w/v), at most 5.0% (w/v), at most 5.5% (w/v), at most 6.0% (w/v), at most 6.5% (w/v), at most 7.0% (w/v), at most 7.5% (w/v), at most 8.0% (w/v), at most 8.5% (w/v), at most 9.0% (w/v), at most 9.5% (w/v), at most 10%
(w/v), at most 15% (w/v), at most 20% (w/v), at most 25% (w/v), at most 30%
(w/v), or at most 35% (w/v).
[086] Aspects of the present pharmaceutical compositions provide, in part, a polymer. As used herein, the term "polymer" refers to high molecular weight compounds comprising at least eleven monomeric units.
Polymers consisting of only one kind of repeating unit are called homopolymers, whereas polymers formed from two or more different repeating units and called copolymers. A polymer can be natural or synthetic.
Non-limiting examples of polymers include polysaccharides, such as, e.g., dextrans (like dextran 1K, dextran 4K, dextran 40K, dextran 60K, and dextran 70K), dextrin, glycogen, inulin, starch, starch derivatives (like hydroxymethyl starch, hydroxyethyl starch, hydroxypropyl starch, hydroxybutyl starch, and hydroxpentyl starch), hetastarch, cellulose, FICOLL, methyl cellulose (MC), carboxymethyl cellulose (CMC), hydroxyethyl cellulose (HEC), hydroxypropyl cellulose (HPC), hydroxyethyl methyl cellulose (HEMC), hydroxypropyl methyl cellulose (HPMC); polyvinyl acetates (PVA); polyvinyl pyrrolidones (PVP), also known as povidones, having a K-value of less than or equal to 18, a K-value greater than 18 or less than or equal to 95, or a K-value greater than 95, like PVP 12 (KOLLIDON8 12), PVP 17 (KOLLIDON 17), PVP 25 (KOLLIDON 8 25), PVP 30 (KOLLIDON 30), PVP 90 (KOLLIDON 90); polyethylene glycols like PEG 100, PEG
200, PEG 300, PEG
400, PEG 500, PEG 600, PEG 700, PEG 800, PEG 900, PEG 1000, PEG 1100, PEG
1200, PEG 1300, PEG
1400, PEG 1500, PEG 1600, PEG 1700, PEG 1800, PEG 1900, PEG 2000, PEG 2100, PEG 2200, PEG
2300, PEG 2400, PEG 2500, PEG 2600, PEG 2700, PEG 2800, PEG 2900, PEG 3000, PEG 3250, PEG
3350, PEG 3500, PEG 3750, PEG 4000, PEG 4250, PEG 4500, PEG 4750, PEG 5000, PEG 5500, PEG
6000, PEG 6500, PEG 75000, PEG 7500, or PEG 8000; and polyethylene imines (PEI); polypeptides (proteins) like bovine serum albumin, gelatin, and ovalbumin; polynucleotides like DNA and RNA. Other non-limiting examples of polymer excipients can be found in, e.g., Ansel, supra, (1999); Gennaro, supra, (2000);
Hardman, supra, (2001); and Rowe, supra, (2003) .
[087] It is envisioned that any non-protein polymer is useful in formulating a Clostridial toxin pharmaceutical compositions disclosed in the present specification, with the proviso that a therapeutically effective amount of the Clostridial toxin active ingredient is recovered using this non-protein polymer. Thus in an embodiment, a Clostridial toxin pharmaceutical composition comprises a non-protein polymer.
In an aspect of this embodiment, a Clostridial toxin pharmaceutical composition comprises a polysaccharide. In aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a dextran, an inulin, a starch, a starch derivative, a hetastarch, a dextrin, a glycogen, a cellulose, FICOLL, a methyl cellulose (MC), a carboxymethyl cellulose (CMC), a hydroxyethyl cellulose (HEC), a hydroxypropyl cellulose (HPC), a hydroxyethyl methyl cellulose (HEMC), or a hydroxypropyl methyl cellulose (HPMC). In another aspect of this embodiment, a Clostridial toxin pharmaceutical composition comprises a polyvinyl acetate. In another aspect of this embodiment, a Clostridial toxin pharmaceutical composition comprises a polyvinylpyrrolidone. In aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises dextran 1K, dextran 4K, dextran 40K, dextran 60K, or dextran 70K. In another aspect of this embodiment, a Clostridial toxin pharmaceutical composition comprises PVP 12, PVP 17, PVP 25, PVP 30, or PVP 90. In yet another aspect of this embodiment, a Clostridial toxin pharmaceutical composition comprises a polyethylene glycol. In an aspect of this embodiment, a Clostridial toxin pharmaceutical composition comprises a room temperature solid PEG. In aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises PEG 1000, PEG 1100, PEG 1200, PEG 1300, PEG 1400, PEG 1500, PEG 1600, PEG 1700, PEG 1800, PEG
1900, PEG 2000, PEG 2100, PEG 2200, PEG 2300, PEG 2400, PEG 2500, PEG 2600, PEG 2700, PEG
2800, PEG 2900, PEG 3000, PEG 3250, PEG 3350, PEG 3500, PEG 3750, PEG 4000, PEG 4250, PEG
4500, PEG 4750, PEG 5000, PEG 5500, PEG 6000, PEG 6500, PEG 75000, PEG 7500, or PEG 8000. In another aspect of this embodiment, a Clostridial toxin pharmaceutical composition comprises a polyethylene imine.
[088] It is envisioned that any amount of non-protein polymer is useful in formulating a Clostridial toxin pharmaceutical compositions disclosed in the present specification, with the proviso that a therapeutically effective amount of the Clostridial toxin active ingredient is recovered using this non-protein polymer amount.
In aspects of this embodiment, the amount of non-protein polymer added to the formulation is about 0.1%
(w/v), about 0.5% (w/v), about 1.0% (w/v), about 1.5% (w/v), about 2.0% (w/v), about 2.5% (w/v), about 3.0%
(w/v), about 3.5% (w/v), about 4.0% (w/v), about 4.5% (w/v), about 5.0% (w/v), about 5.5% (w/v), about 6.0%
(w/v), about 6.5% (w/v), about 7.0% (w/v), about 7.5% (w/v), about 8.0% (w/v), about 8.5% (w/v), about 9.0%
(w/v), about 9.5% (w/v), about 10% (w/v), about 15% (w/v), about 20% (w/v), about 25% (w/v), about 30%
(w/v), or about 35% (w/v). In other aspects of this embodiment, the amount of non-protein polymer added to the formulation is at least 0.1% (w/v), at least 0.5% (w/v), at least 1.0%
(w/v), at least 1.5% (w/v), at least 2.0% (w/v), at least 2.5% (w/v), at least 3.0% (w/v), at least 3.5% (w/v), at least 4.0% (w/v), at least 4.5%
(w/v), at least 5.0% (w/v), at least 5.5% (w/v), at least 6.0% (w/v), at least 6.5% (w/v), at least 7.0% (w/v), at least 7.5% (w/v), at least 8.0% (w/v), at least 8.5% (w/v), at least 9.0%
(w/v), at least 9.5% (w/v), at least 10%
(w/v), at least 15% (w/v), at least 20% (w/v), at least 25% (w/v), at least 30% (w/v), or at least 35% (w/v). In yet other aspects of this embodiment, the amount of non-protein polymer added to the formulation is at most 0.1% (w/v), at most 0.5% (w/v), at most 1.0% (w/v), at most 1.5% (w/v), at most 2.0% (w/v), at most 2.5%
(w/v), at most 3.0% (w/v), at most 3.5% (w/v), at most 4.0% (w/v), at most 4.5% (w/v), at most 5.0% (w/v), at most 5.5% (w/v), at most 6.0% (w/v), at most 6.5% (w/v), at most 7.0% (w/v), at most 7.5% (w/v), at most 8.0% (w/v), at most 8.5% (w/v), at most 9.0% (w/v), at most 9.5% (w/v), at most 10% (w/v), at most 15% (w/v), at most 20% (w/v), at most 25% (w/v), at most 30% (w/v), or at most 35% (w/v).
[089] Aspects of the present pharmaceutical compositions provide, in part, a surfactant. As used hereon, the term "surfactant" refers to a natural or synthetic amphiphilic compound. A
surfactant can be non-ionic, zwitterionic, or ionic. It is envisioned that any surfactant is useful in formulating a Clostridial toxin pharmaceutical compositions disclosed in the present specification, with the proviso that a therapeutically effective amount of the Clostridial toxin active ingredient is recovered using this surfactant amount. Non-limiting examples of surfactants include polysorbates like polysorbate 20 (TWEEN 20), polysorbate 40 (TWEEN 40), polysorbate 60 (TWEEN 60), polysorbate 61 (TWEEN 61), polysorbate 65 (TWEEN 65), polysorbate 80 (TWEEN 80), and polysorbate 81 (TWEEN 81); poloxamers (polyethylene-polypropylene copolymers), like Poloxamer 124 (PLURONIC L44), Poloxamer 181 (PLURONIC
L61), Poloxamer 182 (PLURONIC L62), Poloxamer 184 (PLURONIC L64), Poloxamer 188 (PLURONIC F68), Poloxamer 237 (PLURONIC F87), Poloxamer 338 (PLURONIC L108), Poloxamer 407 (PLURONIC
F127), polyoxyethyleneglycol dodecyl ethers, like BRIJ 30, and BRIJ 35; 2-dodecoxyethanol (LUBROL -PX);
polyoxyethylene octyl phenyl ether (TRITON X-100); sodium dodecyl sulfate (SDS); 34(3-Cholamidopropyl)d imethylammon io]-1-propanesulfonate (CHAPS); 3-[(3-Cholamidopropyl)dimethylammonio]-2-hydroxy-1-propanesulfonate (CHAPS0); sucrose monolaurate; and sodium cholate. Other non-limiting examples of surfactant excipients can be found in, e.g., Ansel, supra, (1999);
Gennaro, supra, (2000);
Hardman, supra, (2001); and Rowe, supra, (2003) ,
[090] Thus in an embodiment, a Clostridial toxin pharmaceutical composition comprises a surfactant. In aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a polysorbate, a poloxamer, a polyoxyethyleneglycol dodecyl ether, 2-dodecoxyethanol , polyoxyethylene octyl phenyl ether, sodium dodecyl sulfate, 3-[(3-Cholamidopropyl)dimethylammonio]-1-propanesulfonate, 3-[(3-Cholamidopropyl) dimethylammonio]-2-hydroxy-1-propanesulfonate, sucrose monolaurate; or sodium cholate.
[091] It is envisioned that any amount of surfactant is useful in formulating a Clostridial toxin pharmaceutical compositions disclosed in the present specification, with the proviso that a therapeutically effective amount of the Clostridial toxin active ingredient is recovered using this surfactant amount. In aspects of this embodiment, the amount of surfactant added to the formulation is about 0.01%
(w/v), about 0.02% (w/v), about 0.03% (w/v), about 0.04% (w/v), about 0.05% (w/v), about 0.06% (w/v), about 0.07% (w/v), about 0.08% (w/v), about 0.09% (w/v), about 0.1% (w/v), about 0.5% (w/v), about 1.0%
(w/v), about 1.5% (w/v), about 2.0% (w/v), about 2.5% (w/v), about 3.0% (w/v), about 3.5% (w/v), about 4.0% (w/v), about 4.5% (w/v), about 5.0% (w/v), about 5.5% (w/v), about 6.0% (w/v), about 6.5% (w/v), about 7.0% (w/v), about 7.5% (w/v), about 8.0% (w/v), about 8.5% (w/v), about 9.0% (w/v), about 9.5% (w/v), about 10% (w/v), about 15% (w/v), about 20% (w/v), about 25% (w/v), about 30% (w/v), or about 35% (w/v). In other aspects of this embodiment, the amount of surfactant added to the formulation is at least 0.01% (w/v), at least 0.02% (w/v), at least 0.03% (w/v), at least 0.04% (w/v), at least 0.05% (w/v), at least 0.06% (w/v), at least 0.07% (w/v), at least 0.08% (w/v), at least 0.09% (w/v), at least 0.1% (w/v), at least 0.5%
(w/v), at least 1.0% (w/v), at least 1.5% (w/v), at least 2.0% (w/v), at least 2.5% (w/v), at least 3.0% (w/v), at least 3.5% (w/v), at least 4.0%
(w/v), at least 4.5% (w/v), at least 5.0% (w/v), at least 5.5% (w/v), at least 6.0% (w/v), at least 6.5% (w/v), at least 7.0% (w/v), at least 7.5% (w/v), at least 8.0% (w/v), at least 8.5%
(w/v), at least 9.0% (w/v), at least 9.5%
(w/v), at least 10% (w/v), at least 15% (w/v), at least 20% (w/v), at least 25% (w/v), at least 30% (w/v), or at least 35% (w/v). In yet other aspects of this embodiment, the amount of surfactant added to the formulation is at most 0.01% (w/v), at most 0.02% (w/v), at most 0.03% (w/v), at most 0.04%
(w/v), at most 0.05% (w/v), at most 0.06% (w/v), at most 0.07% (w/v), at most 0.08% (w/v), at most 0.09%
(w/v), at most 0.1% (w/v), at most 0.5% (w/v), at most 1.0% (w/v), at most 1.5% (w/v), at most 2.0% (w/v), at most 2.5% (w/v), at most 3.0%
(w/v), at most 3.5% (w/v), at most 4.0% (w/v), at most 4.5% (w/v), at most 5.0% (w/v), at most 5.5% (w/v), at most 6.0% (w/v), at most 6.5% (w/v), at most 7.0% (w/v), at most 7.5% (w/v), at most 8.0% (w/v), at most 8.5% (w/v), at most 9.0% (w/v), at most 9.5% (w/v), at most 10% (w/v), at most 15% (w/v), at most 20% (w/v), at most 25% (w/v), at most 30% (w/v), or at most 35% (w/v).
[092] In aspects of this embodiment, the amount of surfactant added to the formulation is about 0.01%
(v/v), about 0.02% (v/v), about 0.03% (v/v), about 0.04% (v/v), about 0.05%
(v/v), about 0.06% (v/v), about 0.07% (v/v), about 0.08% (v/v), about 0.09% (v/v), about 0.1% (v/v), about 0.5% (v/v), about 1.0% (v/v), about 1.5% (v/v), about 2.0% (v/v), about 2.5% (v/v), about 3.0% (v/v), about 3.5%
(v/v), about 4.0% (v/v), about 4.5% (v/v), about 5.0% (v/v), about 5.5% (v/v), about 6.0% (v/v), about 6.5%
(v/v), about 7.0% (v/v), about 7.5% (v/v), about 8.0% (v/v), about 8.5% (v/v), about 9.0% (v/v), about 9.5%
(v/v), about 10% (v/v), about 15% (v/v), about 20% (v/v), about 25% (v/v), about 30% (v/v), or about 35%
(v/v). In other aspects of this embodiment, the amount of surfactant added to the formulation is at least 0.01% (v/v), at least 0.02% (v/v), at least 0.03% (v/v), at least 0.04% (v/v), at least 0.05% (v/v), at least 0.06%
(v/v), at least 0.07% (v/v), at least 0.08% (v/v), at least 0.09% (v/v), at least 0.1% (v/v), at least 0.5% (v/v), at least 1.0% (v/v), at least 1.5%
(v/v), at least 2.0% (v/v), at least 2.5% (v/v), at least 3.0% (v/v), at least 3.5% (v/v), at least 4.0% (v/v), at least 4.5% (v/v), at least 5.0% (v/v), at least 5.5% (v/v), at least 6.0% (v/v), at least 6.5% (v/v), at least 7.0% (v/v), at least 7.5% (v/v), at least 8.0% (v/v), at least 8.5% (v/v), at least 9.0%
(v/v), at least 9.5% (v/v), at least 10%
(v/v), at least 15% (v/v), at least 20% (v/v), at least 25% (v/v), at least 30% (v/v), or at least 35% (v/v). In yet other aspects of this embodiment, the amount of surfactant added to the formulation is at most 0.01% (v/v), at most 0.02% (v/v), at most 0.03% (v/v), at most 0.04% (v/v), at most 0.05%
(v/v), at most 0.06% (v/v), at most 0.07% (v/v), at most 0.08% (v/v), at most 0.09% (v/v), at most 0.1% (v/v), at most 0.5% (v/v), at most 1.0%
(v/v), at most 1.5% (v/v), at most 2.0% (v/v), at most 2.5% (v/v), at most 3.0% (v/v), at most 3.5% (v/v), at most 4.0% (v/v), at most 4.5% (v/v), at most 5.0% (v/v), at most 5.5% (v/v), at most 6.0% (v/v), at most 6.5%
(v/v), at most 7.0% (v/v), at most 7.5% (v/v), at most 8.0% (v/v), at most 8.5% (v/v), at most 9.0% (v/v), at most 9.5% (v/v), at most 10% (v/v), at most 15% (v/v), at most 20% (v/v), at most 25% (v/v), at most 30%
(v/v), or at most 35% (v/v).
[093] Aspects of the present pharmaceutical compositions provide, in part, an amino acid. As used hereon, the term "amino acid" refers to a molecule with the general formula H2NCHRCOOH, where R is an organic substitute. It is envisioned that any amino acid is useful in formulating a Clostridial toxin pharmaceutical compositions disclosed in the present specification, with the proviso that a therapeutically effective amount of the Clostridial toxin active ingredient is recovered using this amino acid amount. Amino acids include both the twenty standard amino acids and non-standard amino acids. Non-limiting examples of amino acids include glycine, proline, 4-hydroxyproline, serine, glutamate, alanine, lysine, sarcosine, y-aminobutyric acid. Other non-limiting examples of amino acids excipients can be found in, e.g., Ansel, supra, (1999); Gennaro, supra, (2000); Hardman, supra, (2001); and Rowe, supra, (2003).
[094] Thus in an embodiment, a Clostridial toxin pharmaceutical composition comprises an amino acid. In aspects of this embodiment, a Clostridial toxin pharmaceutical composition comprises a glycine, proline, 4-hydroxyproline, serine, glutamate, alanine, lysine, sarcosine, or y-aminobutyric acid.
[095] It is envisioned that any amount of amino acid is useful in formulating a Clostridial toxin pharmaceutical compositions disclosed in the present specification, with the proviso that a therapeutically effective amount of the Clostridial toxin active ingredient is recovered using this amino acid amount. In aspects of this embodiment, the amount of amino acid added to the formulation is about 0.1% (w/v), about 0.5% (w/v), about 1.0% (w/v), about 1.5% (w/v), about 2.0% (w/v), about 2.5%
(w/v), about 3.0% (w/v), about 3.5% (w/v), about 4.0% (w/v), about 4.5% (w/v), about 5.0% (w/v), about 5.5%
(w/v), about 6.0% (w/v), about 6.5% (w/v), about 7.0% (w/v), about 7.5% (w/v), about 8.0% (w/v), about 8.5%
(w/v), about 9.0% (w/v), about 9.5% (w/v), about 10% (w/v), about 15% (w/v), about 20% (w/v), about 25%
(w/v), about 30% (w/v), or about 35% (w/v). In other aspects of this embodiment, the amount of amino acid added to the formulation is at least 0.1% (w/v), at least 0.5% (w/v), at least 1.0% (w/v), at least 1.5% (w/v), at least 2.0% (w/v), at least 2.5%
(w/v), at least 3.0% (w/v), at least 3.5% (w/v), at least 4.0% (w/v), at least 4.5% (w/v), at least 5.0% (w/v), at least 5.5% (w/v), at least 6.0% (w/v), at least 6.5% (w/v), at least 7.0%
(w/v), at least 7.5% (w/v), at least 8.0%
(w/v), at least 8.5% (w/v), at least 9.0% (w/v), at least 9.5% (w/v), at least 10% (w/v), at least 15% (w/v), at least 20% (w/v), at least 25% (w/v), at least 30% (w/v), or at least 35%
(w/v). In yet other aspects of this embodiment, the amount of amino acid added to the formulation is at most 0.1%
(w/v), at most 0.5% (w/v), at most 1.0% (w/v), at most 1.5% (w/v), at most 2.0% (w/v), at most 2.5% (w/v), at most 3.0% (w/v), at most 3.5% (w/v), at most 4.0% (w/v), at most 4.5% (w/v), at most 5.0% (w/v), at most 5.5% (w/v), at most 6.0%
(w/v), at most 6.5% (w/v), at most 7.0% (w/v), at most 7.5% (w/v), at most 8.0% (w/v), at most 8.5% (w/v), at most 9.0% (w/v), at most 9.5% (w/v), at most 10% (w/v), at most 15% (w/v), at most 20% (w/v), at most 25%
(w/v), at most 30% (w/v), or at most 35% (w/v).
[096] It is envisioned that a plurality of non-protein excipients is useful in formulating a Clostridial toxin pharmaceutical compositions disclosed in the present specification, with the proviso that a therapeutically effective amount of the Clostridial toxin active ingredient is recovered using this plurality of non-protein excipients. Thus in an embodiment, a Clostridial toxin pharmaceutical composition comprises a plurality of non-protein excipients. In aspects of this embodiment, a Clostridial toxin pharmaceutical composition can comprise, e.g., at least two non-protein excipients, at least three non-protein excipients, at least four non-protein excipients, at least five non-protein excipients, at least six non-protein excipients, at least seven non-protein excipients or at least eight non-protein excipients. In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition can comprise, e.g., at most two non-protein excipients, at most three non-protein excipients, at most four non-protein excipients, at most five non-protein excipients, at most six non-protein excipients, at most seven non-protein excipients or at most eight non-protein excipients. In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition can comprise, e.g., 2-10 non-protein excipients, 2-8, non-protein excipients, 2-6 non-protein excipients, 2-4 non-protein excipients, 3-10 non-protein excipients, 3-8, non-protein excipients, 3-6 non-protein excipients, 3-4 non-protein excipients, 4-non-protein excipients, 4-8 non-protein excipients, or 4-6 non-protein excipients. For example, a Clostridial toxin pharmaceutical composition can comprise two different sugars and a Clostridial toxin active ingredient, a Clostridial toxin pharmaceutical composition can comprise a sugar, a surfactant and a Clostridial toxin active ingredient, a Clostridial toxin pharmaceutical composition can comprise a non-protein polymer, a surfactant and a Clostridial toxin active ingredient, or a Clostridial toxin pharmaceutical composition can comprise a sugar, a non-protein polymer, a surfactant and a Clostridial toxin active ingredient.
[097] It is envisioned that any ratio of non-protein excipients is useful in formulating a Clostridial toxin pharmaceutical compositions disclosed in the present specification, with the proviso that a therapeutically effective amount of the Clostridial toxin active ingredient is recovered using this excipient ratio. In aspects of this embodiment, when two non-protein excipients are added to the formulation, the ratio of the first excipient to the second excipient is at least 400:1, at least 300:1, at least 200:1, at least 150:1, at least 100:1, at least 50:1, at least 20:1, at least 15:1, at least 10:1, at least 9:1, at least 8:1, at least 7:1, at least 6:1, at least 5:1, at least 4:1, at least 3:1, at least 2:1, at least 1:1, at least 1:2, at least 1:3, at least 1:4, at least 1:5, at least 1:6, at least 1:7, at least 1:8, at least 1:9, at least 1:10, at least 1:15, at least 1:20, at least 1:50, at least 1:100, at least 1:150, at least 1:200, at least 1:300, or at least 1:400. In other aspects of this embodiment, when three non-protein excipients are added to the formulation, the ratio of the first excipient to the second excipient and third excipient is at least 10:2:1, at least 9:2:1, at least 8:2:1, at least 7:2:1,at least 6:2:1, at least 5:2:1, at least 4:2:1, at least 3:2:1, at least 2:2:1, at least 10:1:1, at least 9:1:1, at least 8:1:1, at least 7:1:1, at least 6:1:1, at least 5:1:1, at least 4:1:1, at least 3:1:1, at least 2:1:1, or at least 1:1:1.
[098] It is further envisioned that a Clostridial toxin pharmaceutical composition disclosed in the present specification can optionally include, without limitation, other pharmaceutically acceptable components (or pharmaceutical components), including, without limitation, buffers, preservatives, tonicity adjusters, salts, antioxidants, osmolality adjusting agents, emulsifying agents, sweetening or flavoring agents, and the like.
Various buffers and means for adjusting pH can be used to prepare a pharmaceutical composition disclosed in the present specification, provided that the resulting preparation is pharmaceutically acceptable. Such buffers include, without limitation, acetate buffers, borate buffers, citrate buffers, phosphate buffers, neutral buffered saline, and phosphate buffered saline. It is understood that acids or bases can be used to adjust the pH of a pharmaceutical composition as needed. It is envisioned that any buffered pH level can be useful in formulating a Clostridial toxin pharmaceutical composition, with the proviso that a therapeutically effective amount of the Clostridial toxin active ingredient is recovered using this effective pH level. In an aspect of this embodiment, an effective pH level is at least about pH 5.0, at least about pH
5.5, at least about pH 6.0, at least about pH 6.5, at least about pH 7.0 or at about about pH 7.5. In another aspect of this embodiment, an effective pH level is at most about pH 5.0, at most about pH 5.5, at most about pH 6.0, at most about pH 6.5, at most about pH 7.0 or at most about pH 7.5. In yet another aspect of this embodiment, an effective pH level is about pH 5.0 to about pH 8.0, an effective pH level is about pH 5.0 to about pH 7.0, an effective pH level is about pH 5.0 to about pH 6.0, is about pH 5.5 to about pH 8.0, an effective pH
level is about pH 5.5 to about pH 7.0, an effective pH level is about pH 5.5 to about pH 5.0, is about pH 5.5 to about pH 7.5, an effective pH
level is about pH 5.5 to about pH pH 6.5.
[099] It is envisioned that any concentration of a buffer can be useful in formulating a Clostridial toxin pharmaceutical composition, with the proviso that a therapeutically effective amount of the Clostridial toxin active ingredient is recovered using this effective concentration of buffer.
In aspects of this embodiment, an effective concentration of buffer is at least 0.1 mM, at least 0.2 mM, at least 0.3 mM, at least 0.4 mM, at least 0.5 mM, at least 0.6 mM, at least 0.7 mM, at least 0.8 mM, or at least 0.9 mM.
In other aspects of this embodiment, an effective concentration of buffer is at least 1.0 mM, at least 2.0 mM, at least 3.0 mM, at least 4.0 mM, at least 5.0 mM, at least 6.0 mM, at least 7.0 mM, at least 8.0 mM, or at least 9.0 mM. In yet other aspects of this embodiment, an effective concentration of buffer is at least 10 mM, at least 20 mM, at least 30 mM, at least 40 mM, at least 50 mM, at least 60 mM, at least 70 mM, at least 80 mM, or at least 90 mM. In still other aspects of this embodiment, an effective concentration of buffer is at least 100 mM, at least 200 mM, at least 300 mM, at least 400 mM, at least 500 mM, at least 600 mM, at least 700 mM, at least 800 mM, or at least 900 mM. In further aspects of this embodiment, an effective concentration of buffer is at most 0.1 mM, at most 0.2 mM, at most 0.3 mM, at most 0.4 mM, at most 0.5 mM, at most 0.6 mM, at most 0.7 mM, at most 0.8 mM, or at most 0.9 mM. In still other aspects of this embodiment, an effective concentration of buffer is at most 1.0 mM, at most 2.0 mM, at most 3.0 mM, at most 4.0 mM, at most 5.0 mM, at most 6.0 mM, at most 7.0 mM, at most 8.0 mM, or at most 9.0 mM. In yet other aspects of this embodiment, an effective concentration of buffer is at most 10 mM, at most 20 mM, at most 30 mM, at most 40 mM, at most 50 mM, at most 60 mM, at most 70 mM, at most 80 mM, or at most 90 mM. In still other aspects of this embodiment, an effective concentration of buffer is at most 100 mM, at most 200 mM, at most 300 mM, at most 400 mM, at most 500 mM, at most 600 mM, at most 700 mM, at most 800 mM, or at most 900 mM. In still further aspects of this embodiment, an effective concentration of buffer is about 0.1 mM to about 900 mM, 0.1 mM to about 500 mM, 0.1 mM to about 100 mM, 0.1 mM to about 90 mM, 0.1 mM to about 50 mM, 1.0 mM to about 900 mM, 1.0 mM to about 500 mM, 1.0 mM to about 100 mM, 1.0 mM to about 90 mM, or 1.0 mM to about 50 mM.
[0100] Pharmaceutically acceptable antioxidants include, without limitation, sodium metabisulfite, sodium thiosulfate, acetylcysteine, butylated hydroxyanisole, and butylated hydroxytoluene. Useful preservatives include, without limitation, benzalkonium chloride, chlorobutanol, thimerosal, phenylmercuric acetate, phenylmercuric nitrate, a stabilized oxy chloro composition, such as, e.g., PURITE and chelants, such as, e.g., DTPA or DTPA-bisamide, calcium DTPA, and CaNaDTPA-bisamide. Tonicity adjustors useful in a pharmaceutical composition include, without limitation, salts such as, e.g., sodium chloride and potassium chloride. The pharmaceutical composition may be provided as a salt and can be formed with many acids, including but not limited to, hydrochloric, sulfuric, acetic, lactic, tartaric, malic, succinic, etc. Salts tend to be more soluble in aqueous or other protonic solvents than are the corresponding free base forms. It is understood that these and other substances known in the art of pharmacology can be included in a pharmaceutical composition useful in the invention. Other non-limiting examples of pharmacologically acceptable components can be found in, e.g., Ansel, supra, (1999); Gennaro, supra, (2000); Hardman, supra, (2001); and Rowe, supra, (2003)
[0101] It is envisioned that any concentration of a salt can be useful in formulating a Clostridial toxin pharmaceutical composition, with the proviso that a therapeutically effective amount of the Clostridial toxin active ingredient is recovered using this effective concentration of salt. In aspects of this embodiment, an effective concentration of salt is at least 0.1 mM, at least 0.2 mM, at least 0.3 mM, at least 0.4 mM, at least 0.5 mM, at least 0.6 mM, at least 0.7 mM, at least 0.8 mM, or at least 0.9 mM.
In other aspects of this embodiment, an effective concentration of salt is at least 1.0 mM, at least 2.0 mM, at least 3.0 mM, at least 4.0 mM, at least 5.0 mM, at least 6.0 mM, at least 7.0 mM, at least 8.0 mM, or at least 9.0 mM. In yet other aspects of this embodiment, an effective concentration of salt is at least 10 mM, at least 20 mM, at least 30 mM, at least 40 mM, at least 50 mM, at least 60 mM, at least 70 mM, at least 80 mM, or at least 90 mM. In still other aspects of this embodiment, an effective concentration of salt is at least 100 mM, at least 200 mM, at least 300 mM, at least 400 mM, at least 500 mM, at least 600 mM, at least 700 mM, at least 800 mM, or at least 900 mM. In further aspects of this embodiment, an effective concentration of salt is at most 0.1 mM, at most 0.2 mM, at most 0.3 mM, at most 0.4 mM, at most 0.5 mM, at most 0.6 mM, at most 0.7 mM, at most 0.8 mM, or at most 0.9 mM. In still other aspects of this embodiment, an effective concentration of salt is at most 1.0 mM, at most 2.0 mM, at most 3.0 mM, at most 4.0 mM, at most 5.0 mM, at most 6.0 mM, at most 7.0 mM, at most 8.0 mM, or at most 9.0 mM. In yet other aspects of this embodiment, an effective concentration of salt is at most 10 mM, at most 20 mM, at most 30 mM, at most 40 mM, at most 50 mM, at most 60 mM, at most 70 mM, at most 80 mM, or at most 90 mM. In still other aspects of this embodiment, an effective concentration of salt is at most 100 mM, at most 200 mM, at most 300 mM, at most 400 mM, at most 500 mM, at most 600 mM, at most 700 mM, at most 800 mM, or at most 900 mM. In still further aspects of this embodiment, an effective concentration of salt is about 0.1 mM to about 900 mM, 0.1 mM to about 500 mM, 0.1 mM to about 100 mM, 0.1 mM to about 90 mM, 0.1 mM to about 50 mM, 1.0 mM
to about 900 mM, 1.0 mM to about 500 mM, 1.0 mM to about 100 mM, 1.0 mM to about 90 mM, or 1.0 mM
to about 50 mM.
[0102] A pharmaceutical compositions disclosed in the present specification generally is administered as a pharmaceutical acceptable composition comprising a botulinum toxin active ingredient. As used herein, the term "pharmaceutically acceptable" means any molecular entity or composition that does not produce an adverse, allergic or other untoward or unwanted reaction when administered to an individual. As used herein, the term "pharmaceutically acceptable composition" is synonymous with "pharmaceutical composition" and means a therapeutically effective concentration of an active ingredient, such as, e.g., any of the Clostridial toxin active ingredients disclosed in the present specification. A
pharmaceutical composition comprising a Clostridial toxin active ingredient is useful for medical and veterinary applications. A pharmaceutical composition may be administered to a patient alone, or in combination with other supplementary active ingredients, agents, drugs or hormones.
[0103] Aspects of the present pharmaceutical compositions provide, in part, recovered potency of a pharmaceutical composition. As used hereon, the term "recovered potency" is synonymous with "recovered activity" and, when used in reference to a solid-form Clostridial toxin pharmaceutical composition, refers to the percentage calculated by dividing the potency of the Clostridial toxin active ingredient in the stored reconstitution formulation by the potency of the active Clostridial toxin ingredient determined prior to its addition into the test solution. When used in reference to an aqueous-form Clostridial toxin pharmaceutical composition, "recovered potency" refers to the percentage calculated by dividing the potency of the Clostridial toxin active ingredient in the stored formulation by the potency of the active Clostridial toxin ingredient determined prior to its addition into the test solution. As used herein, the term "potency" refers to the level of biological activity exhibited by a Clostridial toxin active ingredient as measured by, e.g., a mouse bioassay or an in vitro Clostridial toxin light chain activity assay. As a non-limiting example, with respect to a solid-form Clostridial toxin pharmaceutical composition, a recovery of 60% means that the potency of the Clostridial toxin active ingredient after reconstitution was 60% of the potency of the Clostridial toxin active ingredient prior to its addition to the formulation. As another non-limiting example, with respect to an aqueous -form Clostridial toxin pharmaceutical composition, a recovery of 50% means that the potency of the Clostridial toxin active ingredient after storage was 50% of the potency of the Clostridia! toxin active ingredient prior to its addition to the formulation.
[0104] A wide range of potency or activity assays can be used to determine the recovered potency. For example, for a Clostridial toxin active ingredient having the capacity to cause lethality, an in vivo assay that determines the LD50 value for the Clostridial toxin active ingredient can be used to determine recovered potency, such as, e.g., the mouse lethality assay or the Digit Abduction Score (DAS) assay. Alternatively, a cell-based or in vitro potency assay can be used. As another example, for a Clostridial toxin active ingredient incapable of causing lethality, a cell-based or in vitro activity assay can be used to determine recovered potency. Examples of in vivo potency assays are described in, e.g., Lindstrom and Korkeala, Laboratory Diagnostics of Botulism, Olin. Microbiol. Rev. 19(2): 298-314 (2006) Examples of cell-based potency assays are described in, e.g., Fernandez-Salas, et al., Cell-based Fluorescence Resonance Energy Transfer (FRET) Assays for Clostridial Toxins, U.S. Patent 7,183,066;
Fernandez-Salas, et al., Botulinum Toxin Screening Assays, U.S. Patent 7,598,027; each of which is hereby incorporated by reference in its entirety. Examples of in vitro potency assays are described in, e.g., Steward, et al., FRET Protease Assays for Clostridial Toxins, U.S. Patent 7,332,567;
Williams, et al., Fluoresence Polarization Assays for Determining Clostridial Toxin Acivity, U.S. Patent 7,300,607; Steward, et al., GFP-SNAP25 Fluorescence Release Assay for Botulinum Neurotoxin Protease Activity, U.S. Patent 7,374,896;
Cai, et al., Botulism Diagnostics: From Clinical Symptoms to in vitro Assays, Crit. Rev. Microbiol. 33(2): 109-125 (2007); each of which is hereby incorporated by reference in its entirety.
[0105] It is envisioned that any level of recovered potency is useful in formulating a Clostridial toxin pharmaceutical compositions disclosed in the present specification, with the proviso that a therapeutically effective amount of the Clostridial toxin active ingredient is present. Thus, in an embodiment, a Clostridial toxin pharmaceutical composition disdosed in the present specification exhibits a recovered potency of at least 10%, at least 20%, at least 30%, at least 40%, at least 50%, at least 60%, at least 70%, at least 80%, at least 90%, or at least 100%. In another embodiment, a Clostridial toxin pharmaceutical composition disclosed in the present specification exhibits a recovered potency of at most 10%, at most 20%, at most 30%, at most 40%, at most 50%, at most 60%, at most 70%, at most 80%, at most 90%, or at most 100%. In yet another embodiment, a Clostridia; toxin pharmaceutical composition disclosed in the present specification exhibits a recovered potency of about 20% to about 100%, about 20% to about 90%, about 20% to about 80%, about 20% to about 70%, about 20% to about 60%, or about 20% to about 50%. In still another embodiment, a Clostridial toxin pharmaceutical composition disclosed in the present specification exhibits a recovered potency of about 40% to about 100%, about 40% to about 90%, about 40% to about 80%, about 40% to about 70%, about 40% to about 60%, or about 40% to about 50%.
[0106] Aspects of the present pharmaceutical compositions provide, in part, a pharmaceutical composition form. As used herein, the term "pharmaceutical composition form" refers to whether the pharmaceutical composition is processed into a solid form or aqueous form. Processing a formulation of a pharmaceutical composition into a solid form can be achieved by, e.g., lypholization (freeze-drying) or vacuum-drying.
Processing a formulation of a pharmaceutical composition into an aqueous form can simply be achieved during the compounding stage by the addition of a solute that dissolves or suspends solid excipients to form a solution. Thus, in an embodiment, a Clostridial toxin pharmaceutical composition is in a solid form. In another embodiment, a Clostridial toxin pharmaceutical composition is in an aqueous form.
[0107] Aspects of the present pharmaceutical compositions provide, in part, storage condition of a pharmaceutical composition. As used hereon, the term "storage condition of a pharmaceutical composition"
refers to the location a pharmaceutical composition is stored while in its solid form before reconstitution with an appropriate solution prior to administration. It is envisioned that any storage condition is useful for storing a Clostridial toxin pharmaceutical compositions disclosed in the present specification, with the proviso that a therapeutically effective amount of the Clostridial toxin active ingredient is recovered upon reconstitution with the appropriate solution. In an embodiment, a Clostridial toxin pharmaceutical composition disclosed in the present specification is stored at ambient temperature. In aspects of this embodiment, a Clostridial toxin pharmaceutical composition disclosed in the present specification is stored at an ambient temperature of at least 16 C, at least 18 C, at least 20 C, or at least 22 C. In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition disclosed in the present specification is stored at an ambient temperature of at most 16 C, at most 18 C, at most 20 C, or at most 22 C. In yet other aspects of this embodiment, a Clostridial toxin pharmaceutical composition disclosed in the present specification is stored at an ambient temperature of about 16 C to about 24 C, at about 16 C to about 22 C, at about 16 C to about 20 C, or at about 18 C to about 24 C. In another embodiment, a Clostridial toxin pharmaceutical composition disclosed in the present specification is stored at a temperature below freezing. In aspects of this embodiment, a Clostridial toxin pharmaceutical composition disclosed in the present specification is stored at a temperature of at least 0 C, at least -20 C, at least -70 C, or at least -120 C. In other aspects of this embodiment, a Clostridial toxin pharmaceutical composition disclosed in the present specification is stored at a temperature of at most 0 C, at most -20 C, at most -70 C, or at most -120 C. In yet other aspects of this embodiment, a Clostridial toxin pharmaceutical composition disclosed in the present specification is stored at a temperature of at about 0 C to about -20 C, at about -5 C to about -20 C, at about 0 C to about -15 C, at about -5 C
to about -15 C, at about 0 C to about -70 C, at about -20 C to about -70 C, or at about -20 C to about -120 C.
[0108] Aspects of the present pharmaceutical compositions provide, in part, a Clostridial toxin active ingredient that is stable. For purposes of the present Clostridial toxin pharmaceutical compositions, a Clostridial toxin active ingredient is stable when the recovered potency of the active ingredient when stored for a certain period of time is at least 70% of the initial recovered potency for that active ingredient. For example, a Clostridial toxin active ingredient is stable when the Clostridial toxin pharmaceutical composition containing that Clostridial toxin active ingredient demonstrates, e.g., an initial recovered potency of 100% and a recovered potency of at least 70% when tested one year later, an initial recovered potency of 90% and a recovered potency of at least 63% when tested one year later, an initial recovered potency of 80% and a recovered potency of at least 56% when tested one year later, an initial recovered potency of 70% and a recovered potency of at least 49% when tested one year later, or an initial recovered potency of 60% and a recovered potency of at least 42% when tested one year later.
[0109] Aspects of the Clostridial toxin pharmaceutical compositions disclosed in the present specification can also be described as follows:
1. A citrate-buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient and an effective amount of sucrose, wherein the composition is buffered to about pH 5.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
2. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient and an effective amount of lactose, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
3. A buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient and an effective amount of lactose, wherein the composition is buffered to about pH 5.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
4. A citrate-buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient and an effective amount of lactose, wherein the composition is buffered to about pH 6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
5. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient and an effective amount of lactose in sodium chloride solution, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
6. A phosphate-buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient and an effective amount of dextran 3K, wherein the composition is buffered to about pH 6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
7. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient and an effective amount of PVP 17, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
8. A buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient and an effective amount of PVP 17, wherein the composition is buffered to about pH 5.5 to about pH 6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
9. A citrate-buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient and an effective amount of PVP 17, wherein the composition is buffered to about pH 5.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.

10. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of PVP 17, and an effective amount of sodium chloride, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
11. A citrate-buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient and an effective amount of PEG 3350, wherein the composition is buffered to about pH 5.5 to about pH 6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
12. A histidine-buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient and an effective amount of PEG 3350, wherein the composition is buffered to about pH 5.5 to about pH 6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
13. A citrate-buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient and an effective amount of Poloxamer 188, wherein the composition is buffered to about pH 5.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
14. A citrate-buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient and an effective amount of Poloxamer 188, wherein the composition is buffered to about pH 5.5 to about pH 6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
15. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of lactose and an effective amount of sucrose, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
16. A buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of lactose and an effective amount of sucrose, wherein the composition is buffered to about pH 5.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
17. A phosphate-buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, effective amount of lactose and an effective amount of sucrose, wherein the composition is buffered to about pH 6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.

18. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of lactose, an effective amount of sucrose and an effective amount of sodium chloride, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
19. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of sucrose and an effective amount of PVP 17, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
20. A buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of sucrose and an effective amount of PVP 17, wherein the composition is buffered to about pH 5.5 to about pH 6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
21. A citrate-buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of sucrose and an effective amount of PVP 17, wherein the composition is buffered to about pH 5.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
22. A phosphate-buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of sucrose and an effective amount of PVP 17, wherein the composition is buffered to about pH 5.5 to about pH 6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
23. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of sucrose, an effective amount of PVP 17 and an effective amount of sodium chloride, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
24. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of sucrose and an effective amount of PEG 3350, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
25. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of lactose and an effective amount of PVP 17, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.

26. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of lactose and an effective amount of PEG 3350, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
26. A citrate-buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of lactose and an effective amount of PEG 3350, wherein the composition is buffered to about pH 5.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
27. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of sucrose and an effective amount of Poloxamer 188, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
28. A buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of sucrose and an effective amount of Poloxamer 188, wherein the composition is buffered to about pH 5.5 to about pH 6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
29. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of sucrose, an effective amount of Poloxamer 188, and an effective amount of sodium chloride, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
30. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of sucrose and an effective amount of polysorbate 80, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
31. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of lactose and an effective amount of Poloxamer 188, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
32. A buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of lactose and an effective amount of Poloxamer 188, wherein the composition is buffered to about pH 5.5 to an about pH 6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.

33. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of lactose, an effective amount of Poloxamer 188, and an effective amount of sodium chloride, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
34. A buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of Dextran 3K and an effective amount of PEG
3350, wherein the composition is buffered to about pH 5.5 to about pH 6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
35. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of PVP 17 and an effective amount of PEG 3350, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
36. A buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of PVP 17 and an effective amount of PEG 3350, wherein the composition is buffered to about pH 5.5 to about pH 6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
37. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of Dextran 3K and an effective amount of Poloxamer 188, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
38. A buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of Dextran 3K and an effective amount of Poloxamer 188, wherein the composition is buffered to about pH 5.5 to about pH
6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
39. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of Dextran 40K and an effective amount of Poloxamer 188, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
40. A buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of Dextran 40K and an effective amount of Poloxamer 188, wherein the composition is buffered to about pH 5.5 to about pH
6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
41. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of PVP 17 and an effective amount of Poloxamer 188, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
42. A buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of PVP 17 and an effective amount of Poloxamer 188, wherein the composition is buffered to about pH 5.5 to about pH 6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
43. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of PVP 17, an effective amount of Poloxamer 188, and an effective amount of sodium chloride, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
44. A citrate-buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of PEG 3350 and an effective amount of Poloxamer 188, wherein the composition is buffered to about pH 5.5 to about pH
6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
45. A phosphate-buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of PEG
3350 and an effective amount of Poloxamer 188, wherein the composition is buffered to about pH 5.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
46. A histidine-buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of PEG
3350 and an effective amount of Poloxamer 188, wherein the composition is buffered to about pH 5.5 to about pH 6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
47. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of PVP 17 and an effective amount of Polysorbate 80, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
48. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of sucrose, an effective amount of PVP 17 and an effective amount of Poloxamer 188, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
49. A buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of sucrose, an effective amount of PVP 17 and an effective amount of Poloxamer 188, wherein the composition is buffered to about pH 5.5 to about pH 6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at below freezing temperatures.
50. A phosphate-buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of sucrose, an effective amount of PVP 17 and an effective amount of Poloxamer 188, wherein the composition is buffered to about pH 5.5 to about pH 6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
51. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of sucrose, an effective amount of PVP 17, an effective amount of Poloxamer 188, and an effective amount of sodium chloride, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
52. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of sucrose, an effective amount of lactose and an effective amount of Poloxamer 188, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
53. A buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of sucrose, an effective amount of lactose and an effective amount of Poloxamer 188, wherein the composition is buffered to about pH 5.5 to about pH 6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
54. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of sucrose, an effective amount of PVP 17 and an effective amount of PEG 3350, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
55. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of lactose, an effective amount of PEG 3350 and an effective amount of Poloxamer 188, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.

56. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of Dextran 3K, an effective amount of PEG 3350 and an effective amount of Poloxamer 188, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
57. A buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of Dextran 3K, an effective amount of PEG 3350 and an effective amount of Poloxamer 188, wherein the composition is buffered to about pH 5.5 to about pH 6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
57. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of PVP 17, an effective amount of PEG 3350 and an effective amount of Poloxamer 188, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
58. A buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of PVP 17, an effective amount of PEG 3350 and an effective amount of Poloxamer 188, wherein the composition is buffered to about pH 5.5 to about pH
6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
58. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of PVP 17, an effective amount of glycine and an effective amount of Poloxamer 188, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
59. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of a sugar excipient and an effective amount of surfactant excipient.
60. The composition according to 59, wherein the sugar excipient is a monosaccharide, a disaccharide or a trisaccharide.
61. The composition according to 59, wherein the surfactant excipient is a poloxamer, a polysorbate, a polyoxyethylene glycol dodecyl ether, or a polyoxyethylene octyl phenyl ether.
62. The composition according to 59, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
63. The composition according to 59, wherein the composition is buffered to about pH 5.5 to about pH 6.5.

64. The composition according to 63, wherein the composition is buffered using a citrate buffer, a phosphate buffer or a histidine buffer.
65. The composition according to 59, wherein the composition further comprises an effective amount of sodium chloride.
66. The composition according to 59, wherein the composition further comprises an effective amount of a non-protein polymer excipient.
67. The composition according to 66, wherein the non-protein polymer excipient is a dextran, a polyethylene glycol, a polyethylene imine, a polyvinyl pyrrolidone, a polyvinyl acetate, an inulin, a starch, or a starch derivative.
68. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of a non-protein polymer excipient and an effective amount of surfactant excipient.
69. The composition according to 68, wherein the non-protein polymer excipient is a dextran, a polyethylene glycol, a polyethylene imine, a polyvinyl pyrrolidone, a polyvinyl acetate, an inulin, a starch, or a starch derivative.
70. The composition according to 68, wherein the surfactant excipient is a poloxamer, a polysorbate, a polyoxyethylene glycol dodecyl ether, or a polyoxyethylene octyl phenyl ether.
71. The composition according to 68, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
72. The composition according to 68, wherein the composition is buffered to about pH 5.5 to about pH 6.5.
73. The composition according to 72, wherein the composition is buffered using a citrate buffer, a phosphate buffer or a histidine buffer.
74. The composition according to 68, wherein the composition further comprises an effective amount of sodium chloride.
75. An animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient, an effective amount of a first non-protein polymer excipient, an effective amount of a second non-protein polymer excipient, and an effective amount of surfactant excipient.
76. The composition according to 75, wherein the first non-protein polymer excipient is a dextran, a polyethylene glycol, a polyethylene imine, a polyvinyl pyrrolidone, a polyvinyl acetate, an inulin, a starch, or a starch derivative.
77. The composition according to 75, wherein the second non-protein polymer excipient is a dextran, a polyethylene glycol, a polyethylene imine, a polyvinyl pyrrolidone, a polyvinyl acetate, an inulin, a starch, or a starch derivative.
78. The composition according to 75, wherein the surfactant excipient is a poloxamer, a polysorbate, a polyoxyethylene glycol dodecyl ether, or a polyoxyethylene octyl phenyl ether.
79. The composition according to 75, wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
80. The composition according to 75, wherein the composition is buffered to about pH 5.5 to about pH 6.5.
81. The composition according to 80, wherein the composition is buffered using a citrate buffer, a phosphate buffer or a histidine buffer.
82. The composition according to 75, wherein the composition further comprises an effective amount of sodium chloride.
83. The composition according to 1-82, wherein the Clostridial toxin active ingredient is a Clostridial toxin complex, a Clostriddial toxin, a modified Clostridial toxin or a re-targeted Clostridia! toxin.
84. The composition according to 83, wherein the Clostridial toxin complex is a BoNT/A complex, a BoNT/B
complex, a BoNT/Ci complex, a BoNT/D complex, a BoNT/E complex, a BoNT/F
complex, a BoNT/G
complex, a TeNT complex, a BaNT complex, or a BuNT complex.
85. The composition according to 83, wherein the Clostridial toxin complex is a 900-kDa BoNT/A complex, a 500-kDa BoNT/A complex, a 300-kDa BoNT/A complex, a 500-kDa BoNT/B complex, a 500-kDa BoNT/C1 complex, a 500-kDa BoNT/D complex, a 300-kDa BoNT/D complex, a 300-kDa BoNT/E
complex, or a 300-kDa BoNT/F complex.
86. The composition according to 83, wherein the Clostridial toxin is a BoNT/A, a BoNT/B, a BoNT/Ci, a BoNT/D, a BoNT/E, a BoNT/F, a BoNT/G, a TeNT, a BaNT, or a BuNT.
87. The composition according to 83, wherein the BoNT/A is a BoNT/A1, a BoNT/A2, a BoNT/A3, a BoNT/A4, or a BoNT/A5.
88. The composition according to 83, wherein the re-targeted Clostridial toxin is a re-targeted BoNT/A, a re-targeted BoNT/B, a re-targeted BoNT/Ci, a re-targeted BoNT/D, a re-targeted BoNT/E, a re-targeted BoNT/F, a re-targeted BoNT/G, a re-targeted TeNT, a re-targeted BaNT, or a re-targeted BuNT
89. The composition according to 83, wherein the re-targeted Clostridial toxin comprises an opiod targeting moiety, a tachykinin targeting moiety, a melanocortin targeting moiety, a granin targeting moiety, a Neuropeptide Y related peptide targeting moiety, a neurohormone targeting moiety, a neuroregulatory cytokine targeting moiety, a kinin peptide targeting moiety, a fibroblast growth factor targeting moiety, a nerve growth factor targeting moiety, an insulin growth factor targeting moiety, an epidermal growth factor targeting moiety, a vascular endothelial growth factor targeting moiety, a brain derived neurotrophic factor targeting moiety, a growth derived neurotrophic factor targeting moiety, a neurotrophin targeting moiety, a head activator peptide targeting moiety, a neurturin targeting moiety, a persephrin targeting moiety, an artemin targeting moiety, a transformation growth factor 13 targeting moiety, a bone morphogenic protein targeting moiety, a growth differentiation factor targeting moiety, an activin targeting moiety, a glucagon like hormone targeting moiety, a pituitary adenylate cyclase activating peptide targeting moiety, a growth hormone-releasing hormone targeting moiety, vasoactive intestinal peptide targeting moiety, a gastric inhibitory polypeptide targeting moiety, a calcitonin-related peptidesvisceral gut peptide targeting moiety, or a PAR peptide targeting moiety.
90. The composition according to 89, wherein the opiod targeting moiety is an enkephalin, an endomorphin, an endorphin, a dynorphin, a nociceptin or a hemorphin 91. The composition according to 89, wherein the tachykinin targeting moiety is a Substance P, a neuropeptide K, a neuropeptide gamma, a neurokinin A, a neurokinin B, a hemokinin or a endokinin.
92. A buffered, animal-protein free, solid-form Clostridial toxin pharmaceutical composition comprising a Clostridial toxin active ingredient and an effective amount of trehalose and an effective amount of Poloxamer 188, wherein the composition is buffered to about pH 5.5 to about 6.5, and wherein the Clostridial toxin active ingredient is stable for at least one-year when stored at either ambient or below freezing temperatures.
EXAMPLES
[0110] The following examples set forth specific embodiments of the present Clostridial toxin pharmaceutical compositions and are not intended to limit the scope of the invention.
Example 1 Non-Protein Stabilized Formulations - One Excipient
[0111] Experiments were carried out to determine the effects of formulations comprising a single non-protein excipient on Clostridial toxin active ingredient recovery after reconstitution. The non-protein excipients tested were added separately or in combination with the listed buffers or salts (Table 2). All of the formulations were compounded, lyophilized, reconstituted and potency assessed in the same manner, and with the same Clostridial toxin active ingredient used in each formulation, except that each formulation was prepared with different non-protein excipient or with different amounts of the non-protein excipient.
[0112] Formulations were compounded by first adding the indicated amount of the non-protein excipient(s) to sterile water to form a solution. Next the Clostridial toxin active ingredient was added to the solution to produce the formulation. The Clostridial toxin active ingredient added was about 150 units of a 900-kDaB0NT/A complex, about 150 units of a 150 kDa BoNT/A, or about 250 ng of a 100 kDa re-targeted BoNT/A, where the modification was the substitution of the BoNT/A binding domain with an opiod ligand, see e.g., Steward, L.E. et al., Modified Clostridial Toxins with Enhanced Translocation Capabilities and Altered Targeting Activity For Non-Clostridial Toxin Target Cells, U.S. Patent Application No. 11/776,075 (Jul. 11, 2007); Dolly, J.O. et al., Activatable Clostridial Toxins, U.S. Patent Application No. 11/829,475 (Jul. 27,2007);
Foster, K.A. et al., Fusion Proteins, International Patent Publication WO
2006/059093 (Jun. 8, 2006); and Foster, K.A. et al., Non-Cytotoxic Protein Conjugates, International Patent Publication WO 2006/059105 (Jun.
8, 2006) The formulations were processed into solid forms (either by lyophilization or vacuum drying), stored for a specified period of time (about one-day, at least three months or at least one year), reconstitution with either sterile water or a specified buffer, and then assayed to determine the recovered potency of the Clostridial toxin active ingredient.
[0113] To determine the recovered potency of a Clostridia! toxin, Clostridia]
toxin complex or modified Clostridial toxin, the reconstituted formulation was assayed by a mouse LD50 bioassay. For each reconstituted formulation, a minimum of six serial dilutions at 1.33 dose intervals were prepared in normal saline and typically five or six mice (female Swiss Weber weighing between 17-22 grams) were used in each dosage group. The mice were injected intraperitoneally into the lower right abdomen and the death rates over the ensuing 72 hours for each dilution were recorded. The dilutions were prepared so that the most concentrated dilution produces a death rate of at least 80% of the mice injected, and the least concentration dilution produces a death rate no greater than 20% of the mice injected. A minimum of four dilutions must fall within the monotone decreasing range of the death rates, i.e., the two largest and the two smallest rates must be decreasing (not equivalent). The monotone decreasing range commences with a death rate of no less than 80%. Two reference standard assays are carried out concurrently. The dilution at which 50% of the mice die within the three day post injection observation period is defined as a dilution which comprises one unit (1 U) of the botulinum toxin. The mouse LD50 bioassay provides a determination of the potency of a Clostridial toxin, Clostridial toxin complex or modified Clostridial toxin in terms of its mouse 50% lethal dose or "LD50." Thus, one unit (U) of a Clostridial toxin, Clostridial toxin complex or modified Clostridial toxin is defined as the amount of toxin which upon intraperitoneal injection killed 50% of the mice injected, i.e., LD50.
[0114] Recovery is expressed as a percentage and is calculated by dividing the potency of the Clostridial toxin active ingredient in the stored reconstitution formulation by the potency of the active Clostridial toxin ingredient determined prior to its addition into the test solution. Thus, for example, a recovery of 60% means that the potency of the Clostridial toxin active ingredient after reconstitution was 60% of the potency of the Clostridial toxin active ingredient prior to its addition to the formulation.
The maximum theoretical recovered potency is 100%. The results show that, in general, a Clostridial toxin pharmaceutical composition comprising a Clostridial toxin complex was poorly stabilized when the formulation comprised a single non-protein excipient (Table 2).
[0115] When the single excipient used was a sugar, only the disaccharide lactose exhibited any degree of initial recovered potency, showing about 15% to about 41% recovery of the Clostridial toxin active ingredient when about 10 mg to about 50 mg of lactose was added (about 1% (w/v) to about 5% (w/v))(Table 2).
Furthermore, although exhibiting recovery, the test formulations containing lactose as the single excipient did not appear very stable after one year in storage since recovered potency was not detected at this time for any amount tested except for 20 mg lactose (Table 2). Addition of 10 mM sodium citrate (pH 5.5) and potassium phosphate (pH 5.5) improved both initial recovered potency and long-term stability of the Clostridial toxin active ingredient in Clostridial toxin pharmaceutical compositions containing lactose as the single excipient.
Initial recovered potency increased from about 41% to about 60% when the lactose formulation comprised 10 mM sodium citrate (pH 5.5) and increased from about 41% to about 71% when the lactose formulation comprised 10 mM potassium phosphate (pH 5.5)(Table 2). In addition, increased recovered potency of the Clostridial toxin active ingredient was also observed after at least one-year of storage using either pH 5.5 buffer, as opposed to water, in Clostridial toxin pharmaceutical compositions stored at ambient or freezing temperatures (Table 2). However, addition of 10 mM sodium citrate (pH 6.5) to Clostridial toxin pharmaceutical compositions containing lactose as the single excipient did not improve either initial recovered potency or long-term stability of the Clostridial toxin active ingredient (Table 2). Surprisingly, addition of 10 mM potassium phosphate (pH 6.5) to Clostridial toxin pharmaceutical compositions containing lactose as the single excipient actually eliminated recovery of the Clostridial toxin active ingredient altogether (Table 2).
Lastly, the addition of 10 mM sodium chloride to Clostridial toxin pharmaceutical compositions containing lactose as the single excipient did not improve either recovered potency or long-term stability of the Clostridial toxin active ingredient (Table 2).
[0116] The disaccharides sucrose and trehalose and the trisaccharide raffinose showed no recovered potency of the Clostridial toxin active ingredient whatsoever when used as the single excipient. Furthermore, with one exception, the addition of buffers or sodium chloride to Clostridial toxin pharmaceutical compositions containing these sugars as the single excipient did not improve either initial recovered potency or long-term stability of the Clostridial toxin active ingredient (Table 2). The single exception was the Clostridial toxin pharmaceutical composition comprising sucrose and 10 mM sodium citrate (pH
5.5). This formulation exhibited 44% initial recovered potency of the Clostridial toxin active ingredient and this degree of recover was maintained for at least one year when stored at either ambient or freezing temperatures (Table 2).
[0117] Clostridial toxin pharmaceutical compositions containing a polyol (mannitol) as the single excipient did not exhibit any recovered potency (Table 2). Addition of buffers or sodium chloride to Clostridial toxin pharmaceutical compositions containing mannitol as the single excipient did not improve either recovered potency or long-term stability of the Clostridial toxin active ingredient (Table 2).

Table 2 Formulations using Botulinum Neurotoxin Complex' ¨ One Excipient o _______________________________________________________________________________ __ 0144444444444.1440 W
Excipient 1 Recovered Potencyd (/o) =
1¨
o Ambient Below Frerezih.g 'a o . Ratio Solutiond, Temperature' Temperature' o Type Amount, Initial _________________________ ...months months months ............................................................. month*
Sucrose 5 ¨ Water (pH 5.6) 0 0 0 0 Sucrose 10 Water (pH 5.6) 0 0 0 0 Sucrose 20 Water (pH 5.6) 0 0 0 0 Sucrose 30 Water (pH 5.3) 0 0 0 0 Sucrose 50 Water (pH 5.6) 0 0 0 0 0 n Sucrose 100 Water (pH 5.6) 0 0 0 0 I.) Sucrose 250 Water (pH 5.6) 0 0 0 0 .P
Sucrose 20 10 mM SC (pH 5.5) 44 44 44 39 49 (5) a, I.) .6.
VD Sucrose 20 10 mM SC (pH 6.5) 0 0 0 0 0 In I.) Sucrose 20 10 mM PP (pH 5.5) 0 0 0 0 H
H
Sucrose 20 10 mM PP (pH 6.5) 0 0 0 0 Sucrose 20 ¨ 10 mM NaCI (pH 5.5) 0 0 0 0 0 (5) Sucrose 30 ¨ 10 mM NaCI (pH 5.4) 0 0 0 0 0 ko Sucrose 60 ¨ 10 mM NaCI (pH 5.3) 46 Lactose 5 Water (pH 4.8) 0 0 0 0 Lactose 10 Water (pH 4.8) 15 Lactose 20 Water (pH 4.8) 41 45 38 38 Lactose 50 Water (pH 4.8) 35 1-d n Lactose 20 10 mM SC (pH 5.5) 60 55 55 85 Lactose 20 10 mM SC (pH 6.5) 45 0 0 49 49 cp w Lactose 20 10 mM PP (pH 5.5) 71 46 49 58 55 o o vD
Lactose 20 10 mM PP (pH 6.5) 0 0 0 0 0 'a o, Lactose 20 ¨ 10 mM NaCI (pH 4.8) 39 50 0 58 vi Trehalose 5 Water 0 0 0 0 0 oe Table 2 Formulations using Botulinum Neurotoxin Complex' ¨ One Excipient ........
____________________________________________________________________________ 0144444444444.1440 W
Excipient 1 Recovered Potencyd (%) =
1¨

o Ambient Below Frerezih.g 'a o . Ratio Solutiond, eT mperaturee Temperature' o Type Amounr', Initial _________________________ --.1 3 12 3 12 --.1 ...months months months month*
Trehalose 10 ¨ Water 0 0 0 0 Trehalose 50 Water 0 0 0 0 Raffinose 5 Water 0 0 0 0 Raffinose 10 Water 0 0 0 0 Raffinose 50 Water 0 0 0 0 0 n Mannitol 5 Water 0 0 0 0 I.) Mannitol 10 Water 0 0 0 0 FP
Mannitol 20 Water 0 0 0 0 0 (5) a, I.) vi = Mannitol 50 Water 0 0 0 0 I.) Mannitol 20 10 mM PP (pH 5.5) 0 0 0 0 H
H
lnulin 5 Water 0 0 0 0 lnulin 10 Water 0 0 0 0 0 (5) lnulin 50 Water 0 0 0 0 0 ko Detran 3K 60 Water (pH 5.2) 0 0 0 0 Detran 3K 60 10 mM SC (pH 5.5) 0 0 0 0 Detran 3K 60 10 mM SC (pH 6.5) 0 0 0 0 Detran 3K 60 10 mM PP (pH 5.5) 66 0 0 66 Detran 3K 60 10 mM PP (pH 6.5) 0 0 0 0 0 1-d n Detran 3K 60 10 mM HB (pH 5.5) 0 0 0 0 Detran 3K 60 10 mM HB (pH 6.5) 0 0 0 0 0 cp w Detran 40K 60 Water (pH 5.2) 0 0 0 0 0 o o o Detran 40K 60 10 mM SC (pH 5.5) 0 0 0 0 0 'a o Detran 40K 60 10 mM SC (pH 6.5) 0 0 0 0 vi Detran 40K 60 10 mM PP (pH 5.5) 0 0 0 0 0 oe Table 2 Formulations using Botulinum Neurotoxin Complex' ¨ One Excipient o _______________________________________________________________________________ __ 0144444444444.1440 W
Excipient 1 Recovered Potencyd (/o) =
1¨
o Ambient Below Frerezih.g 'a o . Ratio Solutiond, eT mperaturee Temperature' o Type Amount, Initial _________________________ ...months months months month*
Detran 40K 60 ¨ 10 mM PP (pH 6.5) 0 0 0 0 Detran 40K 60 10 mM HB (pH 5.5) 0 0 0 0 Detran 40K 60 10 mM HB (pH 6.5) 0 0 0 0 PVP 17 0.5 Water (pH 4.2) 0 0 0 0 PVP 17 5 Water (pH 4.2) 48 n PVP 17 10 Water (pH 4.2) 52 I.) PVP 17 20 Water (pH 4.2) 43 0 0 55 FP
PVP 17 30 Water (pH 4.0) 0 0 0 0 0 (5) a, I.) vi 1¨ PVP 17 50 Water (pH 4.2) 0 0 0 0 I.) PVP 17 60 Water (pH 4.0) 55 0 0 46 H
H
PVP 17 100 Water (pH 4.2) 0 0 0 0 PVP 17 250 Water (pH 4.2) 0 0 0 0 0 (5) , PVP 17 20 10 mM SC (pH 5.5) 113 70 41 101 115 ko PVP 17 20 10 mM SC (pH 6.5) 81 44 0 88 PVP 17 20 10 mM PP (pH 5.5) 79 0 0 75 PVP 17 20 10 mM PP (pH 6.5) 83 0 0 69 PVP 17 60 ¨ 10 mM NaCI (pH 3.1) 100 PVP 17 20 ¨ 10 mM NaCI (pH 4.2) 44 0 0 44 1-d n PVP 17 30 ¨ 10 mM NaCI (pH 4.0) 46 PEG 3350 60 Water (pH 7.0) 47 0 0 47 47 cp w PEG 3350 50 Water (pH 7.0) 0 0 0 0 0 o o o PEG 3350 60 10 mM SC (pH 5.5) 76 58 0 87 82 'a o PEG 3350 60 10 mM SC (pH 6.5) 57 0 0 57 vi PEG 3350 60 10 mM PP (pH 5.5) 80 0 0 70 97 oe 'Table 2::
Formulations using Botulinum Neurotoxin Complex' ¨ One Excipient 44444444:e _______________________________________________________________ ..., w Excipient 1 Recovered Potencyd (/o) =
o Ambient Below Frerezing Ratio Solutiond .. eT mperaturee Temperature Type Amount ::: Initial _________________________ ...months months months month PEG 3350 60 ¨ 10 mM PP (pH 6.5) 0 0 0 0 PEG 3350 60 ¨ 10 mM HB (pH 5.5) 72 97 87 110 PEG 3350 60 ¨ 10 mM HB (pH 6.5) 73 73 76 59 Poloxamer 188 50 ¨ Water 0 0 0 0 Poloxamer 188 20 ¨ Water (pH 6.5) 0 0 0 0 0 n Poloxamer 188 20 ¨ 10 mM SC (pH 5.5) 81 73 67 87 I.) Poloxamer 188 20 ¨ 10 mM SC (pH 6.5) 56 0 0 50 FP
Poloxamer 188 20 ¨ 10 mM PP (pH 5.5) 39 0 0 0 0 (5) a, Poloxamer 188 20 ¨ 10 mM PP (pH 6.5) 0 0 0 0 0 in I.) Poloxamer 188 20 ¨ 10 mM NaCI (pH 6.4) 0 0 0 0 H
Glycine 5 ¨ Water 0 0 0 0 I

Glycine 10 ¨ Water 0 0 0 0 0 (5) , Glycine 50 ¨ Water 0 0 0 0 0 l0 a Amount of botulinum neurotoxin serotype A complex added per formulation was 150 units. Total volume of formulation was 1.0 mL.
b For Sucrose, Lactose, Trehalose, Raffinose, Mannitol, Inulin, Detran 3K, Detran 40K, PEG 3550, PVP17, Poloxamer 188, and Glycine, the unit amount of excipient added is in mg. For Polysorbate 20 and Polysorbate 80, the unit amount of excipient added is in mL.
1-d n ,-i c Buffer abbreviations are as follows: SC, sodium citrate buffer; PP potassium phosphate buffer; HB histidine cp buffer; HPB, histidine phosphate buffer.
w o o o d Recovery is expressed as a percentage and is calculated by dividing the potency of the active ingredient -a o determined after reconstitution divided by the potency of the active ingredient determined before addition to the --4 vi formulation. 3 months refers to the length of time a formulation was minimally stored at the indicated temperature. c,.) oe 12 months refers to the length of time a formulation was minimally stored at the indicated temperature.

Table 2 Formulations using Botulinum Neurotoxin Complexa ¨ One Excipient Excipient 1 Recovered Potency (%) Ambient Below Frerezir:g Ratio So I u ti n' Temperaturee Temperature Type AmountbInitial ____________________________________________________ months months months months e Ambient temperature is between about 18 C to about 22 C.
f Below freezing temperature is between about -5 C to about -20 C.
to) cri
[0118] When the single excipient used was a non-protein polymer, recovered potency of the Clostridial toxin active ingredient dependent on the both type of non-protein polymer used and the specific buffer added. For example, Dextran 3K and Dextran 40K showed no initial recovered potency of the Clostridial toxin active ingredient whatsoever when used as the single excipient. On the other hand, the addition of about 60 mg of PEG 3350 (about 2% (w/v)) resulted in an initial recovered potency of about 47%. Similarly the addition of about 5 mg to about 20 mg of PVP 17 (about 0.5% (w/v) to about 2% (w/v)) resulted in an initial recovered potency of about 39% to about 52% (Table 2).
[0119] In general, the addition various buffers did not improve the initial recovered potency of the Clostridial toxin active ingredient when Dextran 3K or Dextran 40K was used as the single excipient. The sole exception was a Clostridial toxin pharmaceutical compositions comprising dextran 3K in 10 mM potassium phosphate (pH 5.5), where initial recovered potency increased from 0% to about 66%, a recovered potency that was maintained for at least one year. Surprisingly, the addition various buffers dramatically improved both recovered potency and long-term stability of the Clostridial toxin active ingredient when PEG 3350 or PVP 17 was used as the single excipient. For example, in Clostridial toxin pharmaceutical compositions comprising PEG 3350, the addition of 10 mM sodium citrate (pH 5.5) increased recovered potency from 0% to about 76%; the addition of 10 mM potassium phosphate (pH 5.5) increased recovered potency from 0% to about 80%; and the addition of 10 mM histidine buffer (pH 5.5) increased recovered potency from 0% to about 72%
(Table 2). In all cases, the addition of these various buffers resulted in long-term stability of at least one-year both at ambient and freezing temperatures.
[0120] Similar, but more complex results were observed in Clostridial toxin pharmaceutical compositions comprising PVP 17 as the single excipient. For example, in Clostridial toxin pharmaceutical compositions comprising PVP 17, the addition of 10 mM sodium citrate (pH 5.5) increased initial recovered potency from about 43% to about 113%; the addition of 10 mM sodium citrate (pH 6.5) increased initial recovered potency from about 43% to about 81%; the addition of 10 mM potassium phosphate (pH
5.5) increased initial recovered potency from about 43% to about 97%; and the addition of 10 mM
potassium phosphate (pH 5.5) increased initial recovered potency from about 43% to about 83%. However, while all buffers tested exhibited increased recovered potency of the Clostridial toxin active ingredient, only the addition of the sodium citrate buffers resulted in long-term stability of at least one year. Lastly, the addition of 10 mM sodium chloride to pharmaceutical compositions containing PVP 17 as the single excipient did not improve either initial recovered potency or long-term stability of the Clostridial toxin active ingredient.
[0121] When the single excipient used was a surfactant, recovered potency of the Clostridial toxin active ingredient dependent was not detected. In addition, use of various buffers resulted in mixed recovered potency. For example, in Clostridial toxin pharmaceutical compositions comprising Poloxamer 188, the addition of 10 mM sodium citrate (pH 5.5) increased initial recovered potency from 0% to about 81%; the addition of 10 mM sodium citrate (pH 6.5) increased initial recovered potency from 0% to about 56%; and the addition of 10 mM potassium phosphate (pH 5.5) increased initial recovered potency from 0% to about 39%;
but the addition of 10 mM potassium phosphate (pH 6.5) did not improve recovery at all (Table 2). However, only the addition of 10 mM sodium citrate (pH 5.5) resulted in long-term stability of the Clostridial toxin active ingredient stored at either ambient or freezing temperatures (Table 2).
[0122] Thus, generally, Clostridial toxin pharmaceutical compositions comprising a single excipient does not result in significant recovered potency of the Clostridial toxin active ingredient, especially when such compositions ate stored for at least one year. Surprisingly, however, both the addition of a buffer to the Clostridial toxin pharmaceutical composition can result in both improved recovered potency and increased long-term stability of the Clostridial toxin active ingredient. However, the pairing of a particular excipeint with a specific buffer can only be determined empirically.
Example 2 Non-Protein Stabilized Formulations - Two Excipients
[0123] Experiments were carried out to determine the effects of formulations comprising two different non-protein excipients on Clostridial toxin active ingredient recovery after reconstitution. The non-protein excipients tested were added separately or in combination with the listed buffers or salts (Tables 3-5). All of the formulations were compounded, lyophilized, reconstituted and potency assessed in the same manner, and with the same Clostridial toxin active ingredient used in each formulation, except that each formulation was prepared with different non-protein excipients or with different amounts of the non-protein excipients.
[0124] The tested formulations were compounded, processed, stored and reconstituted as described in Example 1. Recovered potency was determined using the mouse LD50 bioassay described in Example 1.
Recovery is expressed as a percentage and is calculated by dividing the potency of the Clostridial toxin active ingredient in the stored reconstitution formulation by the potency of the active Clostridial toxin ingredient determined prior to its addition into the test solution. The results show that a Clostridial toxin pharmaceutical composition comprising a Clostridial toxin complex could be stabilized when the formulation comprised two non-protein excipients (Tables 3-5).
[0125] Clostridia! toxin pharmaceutical compositions comprising two different sugars yielded mixed results.
For example, Clostridial toxin pharmaceutical compositions comprising lactose and sucrose did not appear to dramatically improve recovered potency. For example, compositions comprising about 5% (w/v) lactose resulted in an initial recovered potency of about 35% (Table 2), compositions comprising about 5% (w/v) sucrose resulted in no recovered potency (Table 2), and compositions comprising about 5% (w/v) lactose and about 5% (w/v) sucrose resulted in an initial recovered potency of about 27%
(Table 3). Similarly, compositions comprising about 2% (w/v) lactose resulted in an initial recovered potency of about 41% (Table 2), compositions comprising about 1% (w/v) sucrose resulted in no recovered potency (Table 2), and compositions comprising about 2% (w/v) lactose and about 1% (w/v) sucrose resulted in an initial recovered potency of about 68% (Table 3). Although there was an increased initial recovered potency in compositions comprising both about 2% (w/v) lactose and about 1% (w/v) sucrose, long-term stability of the Clostridial toxin active ingredient in Clostridial toxin pharmaceutical compositions comprising about 2% lactose and about 1%sucrose were similar to compositions comprising about 2% (w/v) lactose alone (See Tables 3 & 4).
[0126] Similarly, the addition of 10 mM sodium citrate (pH 5.5), 10 mM sodium citrate (pH 6.5), and 10 mM
potassium phosphate (pH 5.5) had no effect on either initial recovered potency or long-term stability of the Clostridial toxin active ingredient in Clostridial toxin pharmaceutical compositions comprising about 2%
lactose and about 1%sucrose when compared to compositions comprising about 2%
lactose as the sole sugar excipient. Surprisingly, however, in Clostridial toxin pharmaceutical compositions comprising lactose, 2% (w/v), and sucrose, 1% (w/v), the addition of 10 mM potassium phosphate (pH
6.5) increased initial recovered potency from 0% to about 50%, and this formulation was stable for at least one year at freezing temperatures. Similarly striking, in Clostridial toxin pharmaceutical compositions comprising lactose, 2%
(w/v), and sucrose, 1% (w/v), the addition of 10 mM sodium chloride increased initial recovered potency (compare lactose, 2% (w/v), 10 mM sodium chloride at about 39%, sucrose, 2%
(w/v), 10 mM sodium chloride at 0%, and lactose, 2% (w/v), sucrose, 1% (w/v), 10 mM sodium chloride at about 61%). More importantly, this formulation resulted in long-term stability of at least one year at both ambient and freezing temperatures.
[0127] Clostridial toxin pharmaceutical compositions comprising sucrose and either trehalose or mannitol did not improve initial recovered potency, with most combinations resulting in no recovery whatsoever. Similarly, Clostridial toxin pharmaceutical compositions comprising lactose and mannitol did not improve initial recovered potency (compare 5% (w/v) lactose at about 35% (Table 2), 5% (w/v) mannitol at 0% (Table 2), and 5% (w/v) lactose 5% (w/v) and mannitol at about 23% (Table 3)).
[0128] Clostridial toxin pharmaceutical compositions comprising a sugar and a non-protein polymer expanded the range of excipient amounts effective at producing initial recovered potency and long-term stability of the Clostridia! toxin active ingredient. For example, various amount of sucrose in combination with various amount of PVP 17 expanded the range of excipient amounts effective at increased recovered potency and long-term stability of the Clostridial toxin active ingredient. When sucrose was used as the sole excipient at ranges from about 5 mg to about 250 mg (about 0.5% (w/v) to about 25%
(w/v)), no detectable recovered potency of a Clostridial toxin active ingredient was observed, whereas PVP 17 at about 5 mg to about 20 mg (about 0.5% (w/v) to about 2% (w/v)) resulted in an initial recovered potency.
However, Clostridial toxin pharmaceutical compositions comprising about 30 mg to about 250 mg (about 3%
(w/v) to about 25% (w/v)) of sucrose in combination with about 30 mg to about 250 mg (about 3% (w/v) to about 25% (w/v)) of PVP 17 resulted in about 39 to about 62% initial recovered potency of the Clostridial toxin active ingredient (each of these excipients at these amounts alone resulted in no detectable recovery).
As another example, about 5 mg of sucrose (about 0.5% (w/v)) in combination with from about 50 mg of PVP
17 (about 5% (w/v)) increased recovered potency of the Clostridial toxin active ingredient to about 39%
(Table 3) (each of these excipients at these amounts alone resulted in no detectable recovery).

table .3::
Formulations using Botulinum Neurotoxin Complex' ¨ Two Excipients with One Being a Sugar 0 ........
_______________________________________________________________________________ ____________ ¨ w Excipient 1 Excipient 2 Recovered Potency (%) =
:::::
o Amount Ratio Ambient Below Frerezing Solutioe -a, Type Amount b Type Initiale o Temperature Temperature o --.1 :months months months months Sucrose 50 Lactose 50 1:1 Water (pH 4.8) 27 ¨ ¨ ¨ ¨
Sucrose 10 Lactose 20 1:2 Water (pH 4.8) 68 Sucrose 10 Lactose 20 1:2 10 mM SC (pH 5.5) Sucrose 10 Lactose 20 1:2 10 mM SC (pH 6.5) Sucrose 10 Lactose 20 1:2 10 mM PP (pH 5.5) 43 55 49 55 68 n Sucrose 10 Lactose 20 1:2 10 mM PP (pH 6.5) I.) Sucrose 10 Lactose 20 1:2 10 mM NaCI (pH 4.8) FP
Sucrose 50 Trehalose 50 1:1 Water (pH 4.3) 0 0 0 0 0 (5) a, ---1 Sucrose 50 Trehalose 5 10:1 Water (pH 4.3) 0 0 0 0 0 01 I.) Sucrose 5 Trehalose 50 1:10 Water (pH 4.3) 0 H
Sucrose 50 Mannitol 5 10:1 Water (pH 4.3) 0 I

Sucrose 50 Mannitol 50 1:1 Water (pH 4.3) 27 ¨ ¨ ¨ ¨ (5) , Sucrose 5 Mannitol 50 1:10 Water (pH 4.3) 0 0 0 0 0 ko Sucrose 250 PVP 17 10 25:1 Water (pH 4.3) 58 ¨ ¨ ¨ ¨
Sucrose 5 PVP 17 0.5 10:1 Water (pH 4.3) 0 Sucrose 20 PVP 17 10 2:1 Water (pH 4.3) 77 Sucrose 250 PVP 17 250 1:1 Water (pH 4.3) 39 ¨ ¨ ¨ ¨ 1-d n Sucrose 30 PVP 17 30 1:1 Water (pH 4.1) 62 ¨ ¨ ¨ ¨
Sucrose 15 PVP 17 15 1:1 Water (pH 4.1) 77 0 0 68 80 cp w Sucrose 5 PVP 17 5 1:1 Water (pH 4.3) 49 ¨ ¨ ¨ ¨ o o o Sucrose 0.5 PVP 17 0.5 1:1 Water (pH 4.3) 0 0 0 0 0 -a o Sucrose 5 PVP 17 10 1:2 Water (pH 4.3) 58 ¨ ¨ ¨ ¨ --.1 vi Sucrose 5 PVP 17 20 1:4 Water (pH 4.3) 47 ¨ ¨ ¨ ¨ oe table .3::
Formulations using Botulinum Neurotoxin Complex' ¨ Two Excipients with One Being a Sugar 0 ........
_______________________________________________________________________________ ____________ ¨ t..) Excipient 1 Excipient 2 Recovered Potency (%) =
:::::
o Amount Ratio Ambient Below Frerezing Solutioe -a, Type Amount b Type Initiale o Temperature Temperature o --.1 :months months months months Sucrose 5 PVP 17 50 1:10 Water (pH 4.3) 39 ¨ ¨ ¨ ¨
Sucrose 0.5 PVP 17 5 1:10 Water (pH 4.3) 58 ¨ ¨ ¨ ¨
Sucrose 5 PVP 17 100 1:20 Water (pH 4.3) 0 Sucrose 0.5 PVP 17 10 1:20 Water (pH 4.3) 46 ¨ ¨ ¨ ¨
Sucrose 0.5 PVP 17 20 1:40 Water (pH 4.3) 49 ¨ ¨ ¨ ¨ n Sucrose 20 PVP 17 10 2:1 10mM SC (pH 5.5) Sucrose 20 PVP 17 10 2:1 10mM SC (pH 6.5) 87 0 0 88 85 I.) -,1 FP
Sucrose 20 PVP 17 10 2:1 10mM PP (pH 5.5) 65 42 47 83 87 (5) a, oe Sucrose 20 PVP 17 10 2:1 10mM PP (pH 6.5) 63 61 51 75 99 in I.) Sucrose 20 PVP 17 10 2:1 10 mM NaCI (pH 83 I

(5) Sucrose 30 PVP 17 30 1:1 1 0 m M NaCI (pH

4.1) ko Sucrose 15 PVP 17 15 1:1 10 mM NaCI (pH 59 4.1) Sucrose 50 PEG 3350 5 10:1 Water 41 ¨ ¨ ¨ ¨
Sucrose 50 PEG 3350 50 1:1 Water 44 ¨ ¨ ¨ ¨
Sucrose 5 PEG 3350 50 1:10 Water 35 ¨ ¨ ¨ ¨
1-d n ,-i Sucrose 10 Poloxamer 188 0.25 40:1 Water (pH 5.9) Sucrose 5 Poloxamer 188 0.125 40:1 Water (pH 5.7) 70 0 0 70 78 cp w o Sucrose 60 Poloxamer 188 3 20:1 Water (pH 6.1) 75 0 0 84 106 o o -a Sucrose 30 Poloxamer 188 1.5 20:1 Water (pH 6.1) 104 0 0 92 79 o --.1 Sucrose 10 Poloxamer 188 0.5 20:1 Water (pH 6.2) 66 0 0 88 79 vi oe Sucrose 5 Poloxamer 188 0.25 20:1 Water (pH 5.9) Table 3 Formulations using Botulinum Neurotoxin Complex' - Two Excipients with One Being a Sugar 0 ---_______________________________________________________________________________ _________________ - t..) Excipient 1 Excipient 2 Recovered Potency (%) =

o Amount Ratio Ambient Below Frerezing Solution -a, Type Amount b Type Initiale o Temperature Temperature o o months months months months Sucrose 55 Poloxamer 188 5.5 10:1 Water (pH 6.7) 99 0 0 115 115 Sucrose 50 Poloxamer 188 5 10:1 Water Sucrose 27 Poloxamer 188 2.7 10:1 Water (pH 6.2) 92 0 0 80 80 Sucrose 48 Poloxamer 188 12 4:1 Water (pH 6.4) 110 0 0 85 113 Sucrose 24 Poloxamer 188 6 4:1 Water (pH 6.4) 102 0 0 88 84 n Sucrose 10 Poloxamer 188 2.5 4:1 Water (pH 6.4) 84 0 0 104 87 0 Sucrose 5 Poloxamer 188 1.25 4:1 Water (pH 6.4) 72 0 0 92 82 I.) -,1 FP
Sucrose 40 Poloxamer 188 20 2:1 Water (pH 6.9) 113 78 74 102 111 (5) a, vD Sucrose 20 Poloxamer 188 10 2:1 Water (pH 6.5) 101 87 0 117 115 in I.) Sucrose 10 Poloxamer 188 5 2:1 Water (pH 6.9) 94 0 0 92 106 0 H
Sucrose 5 Poloxamer 188 2.5 2:1 Water (pH 6.6) 105 61 0 108 102 H
I

Sucrose 2.5 Poloxamer 188 1.25 2:1 Water (pH 6.4) 87 - - 85 86 (5) Sucrose 1.25 Poloxamer 188 0.625 2:1 Water (pH 6.2) 71 - - 81 90 ko Sucrose 50 Poloxamer 188 50 1:1 Water Sucrose 20 Poloxamer 188 40 1:2 Water (pH 6.9) 115 117 101 117 115 Sucrose 5 Poloxamer 188 50 1:10 Water 55 - - - -Sucrose 60 Poloxamer 188 6 10:1 10mM
SC (pH 5.5) 111 97 101 115 Sucrose 40 Poloxamer 188 20 2:1 10mM
SC (pH 5.5) 113 112 89 115 101 1-d n Sucrose 20 Poloxamer 188 10 2:1 10mM
SC (pH 5.5) 77 81 101 81 115 Sucrose 5 Poloxamer 188 2.5 2:1 10mM
SC (pH 5.5) 92 - - 90 102 cp w Sucrose 2.5 Poloxamer 188 1.25 2:1 10mM SC (pH 5.5) 80 - - 102 80 o o o Sucrose 1.25 Poloxamer 188 0.625 2:1 10mM SC (pH 5.5) 106 - - 102 77 -a o Sucrose 0.625 Poloxamer 188 0.3125 2:1 10mM SC (pH 5.5) 80 - - 92 92 --4 vi Sucrose 20 Poloxamer 188 10 2:1 10mM
SC (pH 6.5) 90 91 67 115 97 oe Table 3 Formulations using Botulinum Neurotoxin Complex' - Two Excipients with One Being a Sugar 0 ---_______________________________________________________________________________ _________________ - t..) Excipient 1 Excipient 2 Recovered Potency (%) =

o Amount Ratio Ambient Below Frerezing Solution -a, Type Amount b Type Initiale o Temperature Temperature o o months months months months Sucrose 20 Poloxamer 188 10 2:1 10mM PP (pH 5.5) Sucrose 20 Poloxamer 188 10 2:1 10mM PP (pH 6.5) Sucrose 20 Poloxamer 188 40 1:2 10mM SC (pH5.5) Sucrose 30 Poloxamer 188 1.5 20:1 10 mM NaCI (pH 6.0) Sucrose 55 Poloxamer 188 5.5 10:1 10 mM NaCI (pH 6.1) 104 0 0 84 84 n Sucrose 27 Poloxamer 188 2.7 10:1 10 mM NaCI (pH 6.1) Sucrose 48 Poloxamer 188 12 4:1 10 mM NaCI (pH 6.2) 96 0 0 97 92 I.) -,1 FP
Sucrose 24 Poloxamer 188 6 4:1 10 mM NaCI (pH 6.2) 100 0 0 66 0 (5) a, o I.) = Sucrose 40 Poloxamer 188 20 2:1 10 mM NaCI (pH 6.4) 84 80 80 102 102 in I.) Sucrose 20 Poloxamer 188 10 2:1 10mM NaCI (pH 6.2) H
Sucrose 5 Poloxamer 188 2.5 2:1 10 mM NaCI (pH 6.1) I

Sucrose 2.5 Poloxamer 188 1.25 2:1 10 mM NaCI (pH 6.0) 92 - - 82 102 (5) Sucrose 1.25 Poloxamer 188 0.625 2:1 10 mM
NaCI (pH 5.8) 85 - - 92 105 ko Sucrose 0.625 Poloxamer 188 0.3125 2:1 10 mM NaCI (pH 5.8) Sucrose 20 Polysorbate 20 0.1 200:1 10 mM PP (pH 6.5) Sucrose 20 Polysorbate 20 0.1 200:1 10 mM HB (pH 6.5) 1-d n Sucrose 10 Polysorbate 80 0.5 20:1 Water (pH 5.8) Sucrose 5 Polysorbate 80 0.25 20:1 Water (pH 5.8) 78 - - 92 92 cp w Sucrose 10 Polysorbate 80 2.5 4:1 Water (pH 6.0) 96 o o Sucrose 5 Polysorbate 80 1.25 4:1 Water (pH 6.0) 102 - - 90 90 -a c., u, Sucrose 50 Glycine 50 1:1 Water 0 0 0 0 0 oe table .3::
Formulations using Botulinum Neurotoxin Complex' ¨ Two Excipients with One Being a Sugar 0 44444444:e _______________________________________________________________________________ _________ w Excipient 1 Excipient 2 Recovered Potency (%) =
:::::
Amountb Ratio Ambient Below Frerezing o Solution -a, Type Amount b Type Initiale o Temperature Temperature o --.1 :months months months months:
Sucrose 50 Glycine 5 10:1 Water 0 Sucrose 5 Glycine 50 1:10 Water 0 Lactose 50 Mannitol 50 1:1 Water 23 ¨
¨ ¨ ¨
n Lactose 5 PVP 17 0.5 10:1 Water 52 ¨ ¨ ¨ ¨ 0 Lactose 5 PVP 17 5 1:1 Water 57 ¨ ¨ ¨ ¨ I.) -,1 FP
Lactose 0.5 PVP 17 0.5 1:1 Water 0 0 0 0 0 (5) a, o I.) 1¨ Lactose 5 PVP 17 10 1:2 Water 65 ¨ ¨ ¨ ¨ 01 Lactose 5 PVP 17 20 1:4 Water 49 ¨ ¨ ¨ ¨ I.) H
Lactose 5 PVP 17 50 1:10 Water 52 ¨ ¨ ¨ ¨ H
I

Lactose 0.5 PVP 17 5 1:10 Water 65 ¨ ¨ ¨ ¨ (5) Lactose 5 PVP 17 100 1:20 Water 0 ¨ ¨ ¨ ¨ ko Lactose 0.5 PVP 17 10 1:20 Water 47 ¨ ¨ ¨ ¨
Lactose 0.5 PVP 17 20 1:40 Water 65 ¨ ¨ ¨ ¨
Lactose 0.5 PVP 17 50 1:100 Water 0 ¨ ¨ ¨ ¨
Lactose 55 PEG 3550 5.5 10:1 Water (pH 4.9) 96 61 62 112 98 1-d n Lactose 40 PEG 3550 20 2:1 Water (pH 5.6) 96 Lactose 50 PEG 3350 50 1:1 Water 53 ¨ ¨ ¨ ¨
cp w Lactose 55 PEG 3550 5.5 10:1 10mM SC (pH 5.5) 96 o o Lactose 40 PEG 3550 20 2:1 10mM SC (pH 5.5) 79 66 70 92 104 -a c., u, c.,.) Lactose 55 Poloxamer 188 5.5 10:1 Water (pH 4.7) 108 80 55 106 92 oe Table 3 Formulations using Botulinum Neurotoxin Complex' - Two Excipients with One Being a Sugar 0 ........
_______________________________________________________________________________ ____________ - t..) Excipient 1 Excipient 2 Recovered Potency (%) =

o Amount Ratio Ambient Below Frerezing Solution -a, Type Amount b Type Initiale o Temperature Temperature o o --.1 months months months months Lactose 40 Poloxamer 188 20 2:1 Water (pH 5.9) 88 60 46 107 104 Lactose 20 Poloxamer 188 10 2:1 Water (pH 5.6) 63 69 0 95 113 Lactose 5 Poloxamer 188 2.5 2:1 Water (pH 5.8) 107 - - 110 106 Lactose 2.5 Poloxamer 188 1.25 2:1 Water (pH 5.8) 87 - - 92 82 Lactose 1.25 Poloxamer 188 0.625 2:1 Water (pH 5.7) 92 - - 96 104 n Lactose 0.625 Poloxamer 188 0.3125 2:1 Water (pH 5.6) 73 - - 66 100 0 Lactose 55 Poloxamer 188 5.5 10:1 10mM
SC (pH 5.5) 100 78 58 96 102 I.) -,1 FP
Lactose 40 Poloxamer 188 20 2:1 10mM
SC (pH 5.5) 93 66 59 107 122 (5) a, o I.) Lactose 20 Poloxamer 188 10 2:1 10mM
SC (pH 5.5) 101 73 69 99 117 in I.) Lactose 5 Poloxamer 188 2.5 2:1 10mM
SC (pH 5.5) 107 - - 92 112 0 H
Lactose 2.5 Poloxamer 188 1.25 2:1 10mM SC (pH 5.5) 86 - - 102 101 H
I

Lactose 1.25 Poloxamer 188 0.625 2:1 10mM SC (pH 5.5) 106 - - 90 107 (5) , Lactose 0.625 Poloxamer 188 0.3125 2:1 10mM SC (pH 5.5) 74 - - 61 81 ko Lactose 20 Poloxamer 188 10 2:1 10mM
SC (pH 6.5) 81 56 56 113 117 Lactose 20 Poloxamer 188 10 2:1 10mM
PP (pH 5.5) 115 88 85 107 114 Lactose 20 Poloxamer 188 10 2:1 10mM
PP (pH 6.5) 91 65 65 103 93 Lactose 20 Poloxamer 188 10 2:1 10 mM
NaCI (pH 5.5) 115 87 101 115 115 Lactose 5 Poloxamer 188 2.5 2:1 10mM NaCI (pH 5.5) 107 - - 92 112 1-d n Lactose 2.5 Poloxamer 188 1.25 2:1 10 mM NaCI (pH 5.5) 86 - - 102 101 Lactose 1.25 Poloxamer 188 0.625 2:1 10mM NaCI (pH 5.5) 106 - - 90 107 cp w Lactose 0.625 Poloxamer 188 0.3125 2:1 10 mM NaCI (pH 5.5) 74 - - 61 81 o o o -a o Trehalose 50 Mannitol 50 10:1 Water 0 vi Trehalose 50 Mannitol 5 1:1 Water 0 0 0 0 0 oe table .3::
Formulations using Botulinum Neurotoxin Complex' ¨ Two Excipients with One Being a Sugar 0 44444444:e _______________________________________________________________________________ _________ ..., w Excipient 1 Excipient 2Recovered Potency (%) b =
:::::
o Ratio Solutioe Ambient Below Frerezing Amount -a, Type Amount Type Initiale f o Temperature Temperature --.1 :months months months months:
Trehalose 5 Mannitol 50 1:10 Water 0 Trehalose 50 PEG 3350 5 10:1 Water 41 ¨ ¨ ¨ ¨
Trehalose 50 PEG 3350 50 1:1 Water 0 Trehalose 5 PEG 3350 50 1:10 Water 36 ¨ ¨ ¨ ¨ n Trehalose 50 Poloxamer 188 5 10:1 Water 50 ¨ ¨ ¨ ¨ I.) -,1 FP
Trehalose 50 Poloxamer 188 50 1:1 Water 53 ¨ ¨ ¨ ¨ (5) o I.) c..) Trehalose 5 Poloxamer 188 50 1:10 Water 75 ¨ ¨ ¨ ¨ 01 I.) Trehalose 40 Poloxamer 188 20 2:1 50 mM HPB (pH 6.5) 175 94 ¨ 98 98 0 H
Trehalose 20 Poloxamer 188 40 1:2 50 mM HPB (pH 6.5) 171 100 ¨ 100 100 H
I

5) (5) i Trehalose 20 Poloxamer 188 40 1:2 50 mM HPB (pH 6.
183 97 ¨100 100 3.3 mM NaCI

ko Trehalose 50 Glycine 5 10:1 Water 0 Trehalose 50 Glycine 50 1:1 Water 0 Trehalose 5 Glycine 50 1:10 Water 0 a Amount of botulinum neurotoxin serotype A complex added per formulation was 150 units. Total volume of formulation was 1.0 mL. 1-d n ,-i b For Sucrose, Lactose, Trehalose, Raffinose, Mannitol, Inulin, Detran 3K, Detran 40K, PEG 3550, PVP17, Poloxamer 188, and Glycine, the unit amount of excipient added is in mg. For Polysorbate 20 and Polysorbate 80, the unit amount of excipient added is in mL. cp w o o o c Buffer abbreviations are as follows: SC, sodium citrate buffer; PP potassium phosphate buffer; HB histidine buffer; HPB, histidine phosphate -a buffer.
o --.1 vi c.,.) oe d Recovery is expressed as a percentage and is calculated by dividing the potency of the active ingredient determined after reconstitution Table 3 Formulations using Botulinum Neurotoxin Complexa ¨ Two Excipients with One Being a Sugar 0 Excipient 1 Excipient 2 Recovered Potencyd (%) b b Ratio solution, Ambient Below Frerezing Type Amount Amount Type AmountInitial Temperature' Temperature months months months months divided by the potency of the active ingredient determined before addition to the formulation. 3 months refers to the length of time a formulation was minimally stored at the indicated temperature. 12 months refers to the length of time a formulation was minimally stored at the indicated temperature.
e Ambient temperature is between about 18 C to about 22 C.
f Below freezing temperature is between about -5 C to about -20 C.
[0129] Depending on the amounts added, the addition of various buffers to Clostridial toxin pharmaceutical compositions comprising sucrose and PVP 17 affected the initial recovered potency or long-term stability of the Clostridial toxin active ingredient (Table 3). For example, Clostridial toxin pharmaceutical compositions comprising about 20 mg sucrose and 10 mg PVP 17 resulted in an initial recovered potency of about 77%
(Table 2). However, the addition of a sodium citrate buffer to this formulation resulted in an increased recovered potency of about 87% to about 100% (Table 3). Furthermore, the addition of an about pH 5.5 sodium citrate buffer to Clostridial toxin pharmaceutical compositions comprising about 20 mg sucrose and 10 mg PVP 17 resulted in at least one year long-term stability when stored at either ambient or below freezing temperatures (Table 3). Likewise, although not increasing the degree of initial recovered potency observed, Clostridial toxin pharmaceutical compositions comprising about 20 mg sucrose and 10 mg PVP 17 in about pH 5.5 to about pH 6.5 potassium phosphate buffer resulted in significantly increased long term stability of the formulations stored at ambient temperatures (Table 3).
[0130] In Clostridial toxin pharmaceutical compositions comprising sucrose and PVP 17, the addition of sodium chloride to the formulation did not appear to have a great effect on initial recovered potency.
However, Clostridial toxin pharmaceutical compositions comprising about 20 mg sucrose and 10 mg PVP 17 in sodium chloride resulted in significantly increased long term stability of the formulations stored at ambient temperatures (Table 3).
[0131] As another example, although no detectable recovered potency was observed when about 5 mg to about 50 mg of sucrose (about 0.5 (w/v) to about 5% (w/v)) was used as the sole excipient, or when about 50 mg of PEG 3350 (about 5% (w/v)) was used as the sole excipient, in combination about 35% to about 44%
increased recovered potency of the Clostridial toxin active ingredient was exhibited (Table 3).
[0132] Clostridial toxin pharmaceutical compositions comprising lactose and a non-protein polymer also expanded the range of excipient amounts effective at producing initial recovered potency and long-term stability of the Clostridial toxin active ingredient. For example, when used as the sole excipient, lactose was effective at increasing recovered potency at about 10 mg to about 50 mg (about 1% (w/v) to about 5% (w/v)) (Table 2), whereas PVP 17 was effective at increasing recovered potency at about 5 mg to about 20 mg (about 0.5% (w/v) to about 2% (w/v)) (Table 2). However, about 5 mg of lactose (about 0.5% (w/v)) in combination with from about 0.5 mg of PVP 17 (about 0.05% (w/v)) increased initial recovered potency of the Clostridial toxin active ingredient to about 52% (Table 3) (each of these excipients at these amounts alone resulted in no detectable recovery, see Table 2). As another example, about 5 mg of lactose (about 0.5%
(w/v)) in combination with from about 50 mg of PVP 17 (about 5% (w/v)) increased initial recovered potency of the Clostridial toxin active ingredient to about 52% (Table 3) (each of these excipients at these concentrations alone resulted in no detectable recovery, see Table 2).
[0133] Furthermore, the addition of lactose, at amounts this sugar alone is ineffective to produce initial recovered potency of the Clostridial toxin active ingredient, appeared to enhance initial recovered potency in Clostridial toxin pharmaceutical compositions comprising an amount of PVP 17 sufficient to produce an initial recovered potency as the sole excipient. For example, about 5 mg of lactose (0.5% (w/v)) in combination with about 5 mg to about 20 mg of PVP 17 (about 0.5% (w/v) to about 2% (w/v)) increased initial recovered potency of the Clostridial toxin active ingredient to about 57%, about 65%, and about 49%, respectively (Table 3). This recovered potency is significantly higher that the recovery observed when PVP 17 is used as the sole excipient (See Table 2, 5 mg of PVP 17, 0.5% (w/v) alone at about 48%; 10 mg of PVP 17, 1% (w/v) alone at about 52%; 20 mg of PVP 17, 2% (w/v) alone at about 43%). Similarly, about 0.5 mg of lactose (0.05% (w/v)) in combination with about 5 mg to about 20 mg of PVP 17 (about 0.5% (w/v) to about 2% (w/v)) increased initial recovered potency of the Clostridial toxin active ingredient to about 65%, about 47%, and about 65%, respectively (Table 3). In general, this recovered potency is significantly higher that the recovery observed when PVP 17 is used as the sole excipient (See Table 2, 5 mg of PVP
17, 0.5% (w/v) alone at about 48%; 10 mg of PVP 17, 1% (w/v) alone at about 52%; 20 mg of PVP 17,2%
(w/v) alone at about 43%).
[0134] Similar results where seen when lactose was combined with PEG 3350.
Clostridial toxin pharmaceutical compositions comprising about 50 mg lactose (about 5% (w/v)) resulted in an initial recovered potency of 35% (Table 2), whereas, Clostridial toxin compositions comprising about 50 mg PEG 3350 (about 5% (w/v)) resulted in no initial recovered potency of the Clostridial toxin active ingredient (Table 2). However, Clostridial toxin compositions comprising about 50 mg lactose (about 5% (w/v)) and about 50 mg PEG 3350 (about 5% (w/v)) resulted in an initial recovered potency of 53% (Table 3).
Enhancement of initial recovered potency was also observed in Clostridial toxin compositions comprising about lactose and PEG 3350 in various buffered solutions (see Table 3).
[0135] Clostridial toxin pharmaceutical compositions comprising a sugar and a surfactant resulted in an effective increased recovered potency and long-term stability of the Clostridial toxin active ingredient over a wide range of excipient amounts. For example, both sucrose alone and Poloxamer 188 alone resulted in no detectable recovered potency of a Clostridial toxin active ingredient (Table 2). Surprisingly Clostridial toxin pharmaceutical compositions comprising from about 1.25 mg to about 60 mg of sucrose (about 0.125% (w/v) to about 6% (w/v)) in combination with about 0.25 mg to about 50 mg of Poloxamer 188 (about 0.025% (w/v) to about 5% (w/v)), all resulted in increased recovered potency of the Clostridial toxin active ingredient of about 43% to about 115% (Table 3). In addition, all such combinations resulted in long-term stability of at least one year of the Clostridial toxin active ingredient when stored at least at below freezing temperatures (Table 3).
[0136] Interestingly, in Clostridial toxin pharmaceutical compositions comprising sucrose and Poloxamer 188, the addition of various buffers to the formulation did not appear to have a great effect on initial recovered potency or long-term stability of the Clostridial toxin active ingredient when stored at below freezing temperatures (Table 3). Surprisingly, however, the addition of various buffers to Clostridial toxin pharmaceutical compositions comprising sucrose and Poloxamer 188 dramatically improved long-term stability of the Clostridial toxin active ingredient when stored at ambient temperatures (Table 3). The addition of sodium chloride to Clostridial toxin pharmaceutical compositions comprising sucrose and Poloxamer 188 did not appear to have a great affect on initial recovered potency or long-term stability of the Clostridial toxin active ingredient (Table 3).
[0137] Similar results where seen when sucrose was combined with polysorbate 80. Clostridial toxin compositions comprising about sucrose as the sole excipient resulted in no detectable recovered potency of a Clostridial toxin active ingredient (Table 2). However, Clostridial toxin compositions comprising about 10 mg to about 20 mg sucrose (about 1% (w/v) to about 2% (w/v)) and about 0.25 mg to about 2.5 mg polysorbate 80 (about 0.025% (w/v) to about 0.25% (w/v)) resulted in an initial recovered potency of about 78% to about 102% (Table 3). The enhancement of long term stability was also observed in Clostridial toxin compositions comprising about sucrose and polysorbate 80 (see Table 3).
[0138] As another example, both sucrose alone and Poloxamer 188 alone resulted in no detectable recovered potency of a Clostridial toxin active ingredient (Table 2).
Surprisingly Clostridial toxin pharmaceutical compositions comprising from about 1.25 mg to about 60 mg of sucrose (about 0.125% (w/v) to about 6% (w/v)) in combination with about 0.25 mg to about 50 mg of Poloxamer 188 (about 0.025% (w/v) to about 5% (w/v)), all resulted in increased recovered potency of the Clostridial toxin active ingredient of about 43% to about 115% (Table 3). In addition, all such combinations resulted in long-term stability of at least one year of the Clostridial toxin active ingredient when stored at least at below freezing temperatures (Table 3).
[0139] Clostridial toxin pharmaceutical compositions comprising lactose and Poloxamer 188 also expanded the range of excipient amounts effective at producing initial recovered potency and long-term stability of the Clostridial toxin active ingredient. For example, when used as the sole excipient, lactose was effective at recovering the Clostridial toxin active ingredient at about 10 mg to about 50 mg (about 1% (w/v) to about 5%
(w/v)) (Table 2), whereas Poloxamer 188 alone resulted in no detectable recovered potency of a Clostridial toxin active ingredient (Table 2). However, about 0.625 to about 5 mg of lactose (about 0.0625% (w/v) to about 0.5% (w/v)) in combination with about 0.3125 mg to about 2.5 mg Poloxamer 188 (about 0.03125%
(w/v) to about 0.25% (w/v)) increased initial recovered potency of the Clostridial toxin active ingredient to about 73% to about 107 (Table 3) (each of these excipients at these amounts alone resulted in no detectable recovery, see Table 2). In addition, all such combinations resulted in long-term stability of at least one year of the Clostridial toxin active ingredient when stored at least at below freezing temperatures (Table 3).
[0140] Furthermore, the addition of Poloxamer 188, at amounts this surfactant alone is ineffective to produce recovery of the Clostridial toxin active ingredient, appeared to enhance initial recovered potency in Clostridial toxin pharmaceutical compositions comprising an amount of lactose sufficient to produce an initial recovered potency as the sole excipient. For example, about 20 mg to about 55 mg of lactose (about 2% (w/v) to about 5.5% (w/v)) in combination with about 5.5 mg to about 20 mg of Poloxamer 188 (about 0.55% (w/v) to about 2% (w/v)) increased initial recovered potency of the Clostridial toxin active ingredient to about 63% to about 108% (Table 3). This recovered potency is significantly higher that the recovery observed when lactose was used as the sole excipient (See Table 2, 10 mg of lactose, 1% (w/v) alone at about 15%; 20 mg of lactose, 2%

(w/v) alone at about 41%; 50 mg of lactose, 5% (w/v) alone at about 35%).
[0141] Depending on the amounts added, the addition of various buffers to Clostridial toxin pharmaceutical compositions comprising lactose and Poloxamer 188 affected the initial recovered potency or long-term stability of the Clostridial toxin active ingredient (Table 3). For example, Clostridial toxin pharmaceutical compositions comprising about 20 mg lactose and 10 mg Poloxamer 188 resulted in an initial recovered potency of about 63% (Table 2). However, the addition of an about pH 5.5 to an about pH 6.5 buffered solution to this formulation resulted in an increased initial recovered potency of about 81% to about 115%
(Table 3). Likewise, the addition of a buffer to these formulations resulted in enhanced long-term stability of at least one year when stored at either ambient or below freezing temperatures.
Similarly, the addition of sodium chloride to Clostridial toxin pharmaceutical compositions comprising lactose and Poloxamer 188, although not having a dramatic affect on initial recovered potency, greatly increased long-term stability of the Clostridial toxin active ingredient, especially at when stored at ambient temperatures (Table 3).
[0142] Clostridial toxin pharmaceutical compositions comprising two non-protein polymers resulted in enhanced recovered potency and long-term stability of the Clostridial toxin active ingredient. For example, the addition of Dextran 3K, at amounts this non-protein polymer alone is ineffective to produce initial recovered potency of the Clostridial toxin active ingredient, appeared to enhance initial recovered potency in Clostridial toxin pharmaceutical compositions comprising an amount of PEG 3350 sufficient to produce an initial recovered potency as the sole excipient. Thus, compositions comprising both Dextran 3K and PEG
3350 exhibited enhanced initial recovered potency in water (compare 0% initial recovered potency of PEG
3350 alone (Table 2) with 47% initial recovered potency Dextran 3K and PEG
3350 together (Table 4)); in sodium citrate buffers (compare 76% initial recovered potency of PEG 3350 alone in sodium citrate buffer (pH
5.5)(Table 2) with 92% initial recovered potency Dextran 3K and PEG 3350 together in sodium citrate buffer (pH 5.5)(Table 4); and 57% initial recovered potency of PEG 3350 alone in sodium citrate buffer (pH
6.5)(Table 2) with 82% initial recovered potency Dextran 3K and PEG 3350 together in sodium citrate buffer (pH 6.5)(Table 4)); potassium phosphate buffers (compare 80% initial recovered potency of PEG 3350 alone in potassium phosphate buffer (pH 5.5)(Table 2) with 101% initial recovered potency Dextran 3K and PEG
3350 together in potassium phosphate buffer (pH 5.5)(Table 4); and 0% initial recovered potency of PEG
3350 alone in potassium phosphate buffer (pH 6.5)(Table 2) with 102% initial recovered potency Dextran 3K
and PEG 3350 together in potassium phosphate buffer (pH 5.5)(Table 4)); and histidine buffers (compare 72% initial recovered potency of PEG 3350 alone in potassium phosphate buffer (pH 5.5)(Table 2) with 82%
initial recovered potency Dextran 3K and PEG 3350 together in histidine buffer (pH 5.5)(Table 4)).
[0143] Clostridia! toxin pharmaceutical compositions comprising PVP 17 and PEG
3350 expanded the range of excipient amounts effective at producing initial recovered potency and long-term stability of the Clostridial toxin active ingredient. For example, when PVP 17 was used as the sole excipient at ranges from about 30 mg to about 250 mg (about 3% (w/v) to about 25% (w/v)), no detectable recovered potency of a Clostridial toxin active ingredient was observed, whereas PEG 3350 only resulted in initial recovered potency at amounts above about 60 mg (about 6% (w/v))(Table 2). However, Clostridial toxin pharmaceutical compositions comprising about 30 mg to about 40 mg PVP 17 (about 3% (w/v) to about 4%
(w/v)) in combination with about 20 mg to about 30 mg of PEG 3350 (about 2% (w/v) to about 3% (w/v)) resulted in initial recovered potency of about 80% (Table 4)(each of these excipients alone resulted in no detectable initial recovered potency).
Likewise, when PEG 3350 was used as the sole excipient at ranges above about 60 mg (about 6% (w/v)), no detectable recovered potency of a Clostridial toxin active ingredient was observed, whereas PVP 17 at about mg to about 20 mg (about 0.5% (w/v) to about 2% (w/v)) resulted in an initial recovered potency (Table 2).
However, Clostridial toxin pharmaceutical compositions comprising about 40 mg to about 55 mg (about 4%
(w/v) to about 5.5% (w/v)) of PEG 3350 in combination with about 20 mg (about 2% (w/v)) of PVP 17 resulted in about 68% initial recovered potency of the Clostridial toxin active ingredient (20 mg (about 2% (w/v)) of PVP 17 alone resulted in a 43% initial recovered potency)(Table 4). This enhanced initial recovery was also observed when various buffered solutions were added to the formulations (Table 4).
[0144] Clostridial toxin pharmaceutical compositions comprising a non-protein polymer and a surfactant resulted in an effective increased recovered potency and long-term stability of the Clostridial toxin active ingredient. For example, both Dextran 3K and Poloxamer 188 alone resulted in no detectable recovered potency of a Clostridial toxin active ingredient (Table 2). Surprisingly Clostridial toxin pharmaceutical compositions comprising both Dextran 3K and Poloxamer 188 resulted in an initial recovered potency of the Clostridial toxin active ingredient of about 78% to about 98% (Table 4).
Furthermore, this synergistic effect was also observed in Clostridial toxin pharmaceutical compositions comprising Dextran 3K and Poloxamer 188 in buffered solutions (Table 4). Both Dextran 3K and Poloxamer 188 alone resulted in no detectable recovered potency of a Clostridial toxin active ingredient in formulations comprising sodium citrate buffers or potassium phosphate buffer (pH 6.5) (Table 2). However, Clostridial toxin pharmaceutical compositions comprising Dextran 3K and Poloxamer 188 resulted in about 82% to about 100%
initial recovered potency with the addition of sodium citrate buffer (pH 5.5); about 85% to about 99%
initial recovered potency with the addition of sodium citrate buffer (pH 6.5); about 82% to about 103% initial recovered potency with the addition of potassium phosphate buffer (pH 6.5); about 103% to about 125% initial recovered potency with the addition of histidine buffer (pH 5.5); and about 115% to about 134% initial recovered potency with the addition of histidine buffer (pH 6.5). In addition, such buffered Clostridial toxin pharmaceutical compositions resulted in enhanced long-term stability for at least one year. Similarly, enhanced recover was seen in Clostridial toxin pharmaceutical compositions comprising Dextran 3K and Poloxamer 188 in potassium phosphate buffer (pH
5.5) (compare 66% initial recovered potency for Dextran 3K alone (Table 2);
39% initial recovered potency for Poloxamer 188 alone (Table 2); and about 90% to about 120% initial recovered potency for Dextran 3K and Poloxamer 188 together (Table 4). Clostridial toxin pharmaceutical compositions comprising Dextran 3K and Poloxamer 188 in potassium phosphate buffer (pH 5.5) also demonstrated enhanced long-term stability when stored at either ambient or below freezing temperatures.

Ta bl e 4 Formulations using Botulinum Neurotoxin Complex' - Two Excipients with One Being a Non-Protein Polymer Excipient 1 Excipient 2 Recovered Potencyd (1)/0) 0t..) o Ambient Below Frerezing o Li t, Ratio Solutionc Temperatured Temperaturee .
'a Type Amount Type Amount Initial µ vD
o 12 3 12 o, --.1 rnonths months months months --.1 Dextran 3K 55 PEG 3350 5.5 10:1 Water (pH 7.1) 0 Dextran 3K 40 PEG 3350 20 2:1 Water (pH 6.3) 82 Dextran 3K 30 PEG 3350 30 1:1 Water (pH 6.4) 0 Dextran 3K 20 PEG 3350 40 1:2 Water (pH 6.7) 47 Dextran 3K 5.5 PEG 3350 55 1:10 Water (pH 6.9) 47 Dextran 3K 55 PEG 3350 5.5 10:1 10 mM SC (pH 5.5) 82 0 0 92 94 n Dextran 3K 40 PEG 3350 20 2:1 10 mM SC (pH 5.5) 86 I.) -,1 Dextran 3K 30 PEG 3350 30 1:1 10mM SC (pH 5.5) 92 (5) Dextran 3K 20 PEG 3350 40 1:2 10mM SC (pH 5.5) 82 I.) --.1 o in Dextran 3K 5.5 PEG 3350 55 1:10 10mM SC (pH 5.5) 92 0 0 82 82 I.) Dextran 3K 55 PEG 3350 5.5 10:1 10mM SC (pH 6.5) H
I
Dextran 3K 40 PEG 3350 20 2:1 10mM SC (pH 6.5) 104 (5) Dextran 3K 30 PEG 3350 30 1:1 10mM SC (pH 6.5) 82 ko Dextran 3K 20 PEG 3350 40 1:2 10mM SC (pH 6.5) 82 Dextran 3K 5.5 PEG 3350 55 1:10 10mM SC (pH 6.5) 82 Dextran 3K 55 PEG 3350 5.5 10:1 10mM PP (pH 5.5) Dextran 3K 40 PEG 3350 20 2:1 10mM PP (pH 5.5) 59 Dextran 3K 30 PEG 3350 30 1:1 10mM PP (pH 5.5) 82 1-d Dextran 3K 20 PEG 3350 40 1:2 10mM PP (pH 5.5) 104 0 0 96 92 n ,-i Dextran 3K 5.5 PEG 3350 55 1:10 10mM PP (pH 5.5) Dextran 3K 55 PEG 3350 5.5 10:1 10mM PP (pH 6.5) 81 0 0 106 104 cp w o Dextran 3K 40 PEG 3350 20 2:1 10mM PP (pH 6.5) 102 0 0 92 82 o o 'a Dextran 3K 30 PEG 3350 30 1:1 10mM PP (pH 6.5) 82 0 0 82 88 o --.1 Dextran 3K 20 PEG 3350 40 1:2 10mM PP (pH 6.5) 104 0 0 88 88 vi oe Dextran 3K 5.5 PEG 3350 55 1:10 10mM PP (pH 6.5) Ta bl e 4 Formulations using Botulinum Neurotoxin Complex' - Two Excipients with One Being a Non-Protein Polymer Excipient 1 Excipient 2 Recovered Potencyd (1)/0) 0t..) o Ambient Below Frerezing o Li t, Ratio Solutionc Temperatured Temperaturee .
'a Type Amount Type Amount Initial µ vD
o 12 3 12 o, --.1 months months months months --.1 Dextran 3K 55 PEG 3350 5.5 10:1 10mM HB (pH 5.5) Dextran 3K 40 PEG 3350 20 2:1 10mM HB (pH 5.5) Dextran 3K 30 PEG 3350 30 1:1 10mM HB (pH 5.5) 80 Dextran 3K 20 PEG 3350 40 1:2 10mM HB (pH 5.5) 96 Dextran 3K 5.5 PEG 3350 55 1:10 10mM HB (pH 5.5) 82 Dextran 3K 55 PEG 3350 5.5 10:1 10mM HB (pH 6.5) 68 0 0 72 78 o Dextran 3K 40 PEG 3350 20 2:1 10mM HB (pH 6.5) 87 I.) -,1 Dextran 3K 30 PEG 3350 30 1:1 10mM HB (pH 6.5) 84 (5) Dextran 3K 20 PEG 3350 40 1:2 10mM HB (pH 6.5) 70 I.) --.1 in Dextran 3K 5.5 PEG 3350 55 1:10 10mM HB (pH 6.5) 66 0 0 61 54 I.) H
H
I
Dextran 3K 60 Poloxamer 188 3 20:1 Water (pH 5.6) 98 (5) Dextran 3K 55 Poloxamer 188 5.5 10:1 Water (pH 5.9) 78 ko Dextran 3K 40 Poloxamer 188 20 2:1 Water (pH 6.5) 98 Dextran 3K 60 Poloxamer 188 3 20:1 10mM SC (pH 5.5) Dextran 3K 55 Poloxamer 188 5.5 10:1 10mM SC (pH 5.5) Dextran 3K 40 Poloxamer 188 20 2:1 10mM SC (pH 5.5) 85 Dextran 3K 60 Poloxamer 188 3 20:1 10mM SC (pH 6.5) 99 1-d Dextran 3K 55 Poloxamer 188 5.5 10:1 10mM SC (pH 6.5) 85 0 0 128 130 n ,-i Dextran 3K 40 Poloxamer 188 20 2:1 10mM SC (pH 6.5) 93 Dextran 3K 60 Poloxamer 188 3 20:1 10mM PP (pH 5.5) 90 57 57 67 130 cp w o Dextran 3K 55 Poloxamer 188 5.5 10:1 10mM PP (pH 5.5) 95 55 55 128 130 o o Dextran 3K 40 Poloxamer 188 20 2:1 10mM PP (pH 5.5) 120 0 0 115 115 'a o --.1 Dextran 3K 60 Poloxamer 188 3 20:1 10mM PP (pH 6.5) 86 0 0 89 133 vi oe Dextran 3K 55 Poloxamer 188 5.5 10:1 10mM PP (pH 6.5) Ta bl e 4 Formulations using Botulinum Neurotoxin Complex' - Two Excipients with One Being a Non-Protein Polymer Excipient 1 Excipient 2 Recovered Potencyd (1)/0) 0t..) o Ambient Below Frerezing o Li t, Ratio Solutionc Temperatured Temperaturee .
'a Type Amount Type Amount Initial µ vD
o 12 3 12 o, --.1 rnonths months months months --.1 Dextran 3K 40 Poloxamer 188 20 2:1 10mM PP (pH 6.5) 82 Dextran 3K 60 Poloxamer 188 3 20:1 10mM HB (pH 5.5) Dextran 3K 55 Poloxamer 188 5.5 10:1 10mM HB (pH 5.5) Dextran 3K 40 Poloxamer 188 20 2:1 10mM HB (pH 5.5) Dextran 3K 60 Poloxamer 188 3 20:1 10mM HB (pH 6.5) Dextran 3K 55 Poloxamer 188 5.5 10:1 10mM HB (pH 6.5) 115 0 0 128 110 o Dextran 3K 40 Poloxamer 188 20 2:1 10mM HB (pH 6.5) I.) -,1 FP

Dextran 40K 60 Poloxamer 188 3 20:1 Water (pH 5.8) 87 0 0 76 78 a, I.) --.1 w in Dextran 40K 55 Poloxamer 188 5.5 10:1 Water (pH 6.0) 85 0 0 78 77 I.) Dextran 40K 40 Poloxamer 188 20 2:1 Water (pH 6.5) 128 H
I
Dextran 40K 60 Poloxamer 188 3 20:1 10mM SC (pH 5.5) (5) ' Dextran 40K 55 Poloxamer 188 5.5 10:1 10mM SC (pH 5.5) ko Dextran 40K 40 Poloxamer 188 20 2:1 10mM SC (pH 5.5) Dextran 40K 60 Poloxamer 188 3 20:1 10mM SC (pH 6.5) Dextran 40K 55 Poloxamer 188 5.5 10:1 10mM SC (pH 6.5) Dextran 40K 40 Poloxamer 188 20 2:1 10mM SC (pH 6.5) Dextran 40K 60 Poloxamer 188 3 20:1 10mM PP (pH 5.5) Iv Dextran 40K 55 Poloxamer 188 5.5 10:1 10mM PP (pH 5.5) 99 0 0 98 100 n ,-i Dextran 40K 40 Poloxamer 188 20 2:1 10mM PP (pH 5.5) Dextran 40K 60 Poloxamer 188 3 20:1 10mM PP (pH 6.5) 110 0 0 83 98 cp w o Dextran 40K 55 Poloxamer 188 5.5 10:1 10mM PP (pH 6.5) 102 0 0 97 73 o o Dextran 40K 40 Poloxamer 188 20 2:1 10mM PP (pH 6.5) 115 0 0 94 115 'a o --.1 Dextran 40K 60 Poloxamer 188 3 20:1 10mM HB (pH 5.5) 99 0 0 100 100 vi oe Dextran 40K 55 Poloxamer 188 5.5 10:1 10mM HB (pH 5.5) Ta bl e 4 Formulations using Botulinum Neurotoxin Complex' - Two Excipients with One Being a Non-Protein Polymer Excipient 1 Excipient 2 Recovered Potencyd (1)/0) 0t..) o Ambient Below Frerezing o Li t, Ratio Solutionc Temperatured Temperaturee .
'a Type Amount Type Amount Initial µ vD
o 12 3 12 o, --.1 months months months months --.1 Dextran 40K 40 Poloxamer 188 20 2:1 10mM HB (pH 5.5) Dextran 40K 60 Poloxamer 188 3 20:1 10mM HB (pH 6.5) Dextran 40K 55 Poloxamer 188 5.5 10:1 10mM HB (pH 6.5) Dextran 40K 40 Poloxamer 188 20 2:1 10mM HB (pH 6.5) PVP 17 55 PEG 3350 5.5 10:1 Water (pH 6.5) 0 0 0 0 0 o PVP 17 40 PEG 3350 20 2:1 Water (pH 4.6) 80 I.) -,1 PVP 17 30 PEG 3350 30 1:1 Water (pH 5.0) 80 0 0 62 62 a, (5) PVP 17 20 PEG 3350 40 1:2 Water (pH 5.4) 68 0 0 66 66 a, I.) PVP 17 5.5 PEG 3350 55 1:10 Water (pH 4.1) 47 0 0 54 54 I.) PVP 17 55 PEG 3350 5.5 10:1 10mM SC (pH 5.5) H
I
PVP 17 40 PEG 3350 20 2:1 10mM SC (pH 5.5) 76 (5) PVP 17 30 PEG 3350 30 1:1 10mM SC (pH 5.5) 80 ko PVP 17 20 PEG 3350 40 1:2 10mM SC (pH 5.5) 92 PVP 17 5.5 PEG 3350 55 1:10 10mM SC (pH 5.5) PVP 17 55 PEG 3350 5.5 10:1 10mM SC (pH 6.5) -PVP 17 40 PEG 3350 20 2:1 10mM SC (pH 6.5) -PVP 17 30 PEG 3350 30 1:1 10mM SC (pH 6.5) -1-d PVP 17 20 PEG 3350 40 1:2 10mM SC (pH 6.5) -n ,-i PVP 17 5.5 PEG 3350 55 1:10 10mM SC (pH 6.5) -PVP 17 55 PEG 3350 5.5 10:1 10mM PP (pH 5.5) -cp w o PVP 17 40 PEG 3350 20 2:1 10mM PP (pH 5.5) -o o PVP 17 30 PEG 3350 30 1:1 10mM PP (pH 5.5) -'a o PVP 17 20 PEG 3350 40 1:2 10mM PP (pH 5.5) -vi oe PVP 17 5.5 PEG 3350 55 1:10 10mM PP (pH 5.5) -Ta bl e 4 Formulations using Botulinum Neurotoxin Complex' - Two Excipients with One Being a Non-Protein Polymer Excipient 1 Excipient 2 Recovered Potencyd (1)/0) 0t..) o Ambient Below Frerezing o Li t, Ratio Solutionc Temperatured Temperaturee .
'a Type Amount Type Amount Initial µ vD
o 12 3 12 o, --.1 rnonths months months months --.1 PVP 17 55 PEG 3350 5.5 10:1 10mM PP (pH 6.5) -PVP 17 40 PEG 3350 20 2:1 10mM PP (pH 6.5) -PVP 17 30 PEG 3350 30 1:1 10mM PP (pH 6.5) -PVP 17 20 PEG 3350 40 1:2 10mM PP (pH 6.5) -PVP 17 5.5 PEG 3350 55 1:10 10mM PP (pH 6.5) -PVP 17 55 PEG 3350 5.5 10:1 10mM HB (pH 5.5) 92 42 42 54 54 o PVP 17 40 PEG 3350 20 2:1 10mM HB (pH 5.5) 92 I.) -,1 PVP 17 30 PEG 3350 30 1:1 10mM HB (pH 5.5) (5) PVP 17 20 PEG 3350 40 1:2 10mM HB (pH 5.5) 84 I.) --.1 PVP 17 5.5 PEG 3350 55 1:10 10mM HB (pH 5.5) 92 0 0 78 78 I.) PVP 17 55 PEG 3350 5.5 10:1 10mM HB (pH 6.5) 86 H
I
PVP 17 40 PEG 3350 20 2:1 10mM HB (pH 6.5) 92 (5) ' PVP 17 30 PEG 3350 30 1:1 10mM HB (pH 6.5) 78 ko PVP 17 20 PEG 3350 40 1:2 10mM HB (pH 6.5) PVP 17 5.5 PEG 3350 55 1:10 10mM HB (pH 6.5) PVP 17 10 Poloxamer 188 0.25 40:1 Water (pH 4.3) 64 PVP 17 5 Poloxamer 188 0.125 40:1 Water (pH 4.2) Iv PVP 17 60 Poloxamer 188 3 20:1 Water (pH 4.0) 68 0 0 72 72 n ,-i PVP 17 30 Poloxamer 188 1.5 20:1 Water (pH 4.0) 77 PVP 17 10 Poloxamer 188 0.5 20:1 Water (pH 4.3) 82 0 0 82 68 cp w o PVP 17 5 Poloxamer 188 0.25 20:1 Water (pH 4.2) 79 0 0 82 62 o o PVP 17 55 Poloxamer 188 5 10:1 Water (pH 4.1) 78 0 0 53 71 'a o --.1 PVP 17 27 Poloxamer 188 2.7 10:1 Water (pH 4.1) 82 0 0 53 81 vi oe PVP 17 48 Poloxamer 188 12 4:1 Water (pH 4.1) 73 Ta bl e 4 Formulations using Botulinum Neurotoxin Complex' - Two Excipients with One Being a Non-Protein Polymer Excipient 1 Excipient 2 Recovered Potencyd (1)/0) 0t..) o Ambient Below Frerezing o Li t, Ratio Solutionc Temperatured Temperaturee .
'a Type Amount Type Amount Initial µ vD
o 12 3 12 o, --.1 rnonths months months months --.1 PVP 17 24 Poloxamer 188 6 4:1 Water (pH 4.1) 78 0 0 53 65 PVP 17 10 Poloxamer 188 2.5 4:1 Water (pH 4.3) 78 0 0 82 82 PVP 17 5 Poloxamer 188 1.25 4:1 Water (pH 4.3) 80 0 0 68 68 PVP 17 40 Poloxamer 188 20 2:1 Water (pH 4.3) 74 0 0 78 72 PVP 17 20 Poloxamer 188 10 2:1 Water (pH 4.4) 71 0 0 101 97 PVP 17 10 Poloxamer 188 5 2:1 Water (pH 4.4) 79 0 0 83 74 r) PVP 17 5 Poloxamer 188 2.5 2:1 Water (pH 4.4) 63 0 0 82 70 0 I.) PVP 17 20 Poloxamer 188 40 1:2 Water (pH 5.7) 69 0 0 61 67 FP

PVP 17 10 Poloxamer 188 20 1:2 Water (pH 5.2) 77 0 0 91 64 a, I.) vi in PVP 17 5 Poloxamer 188 10 1:2 Water (pH 5.4) 82 0 0 117 68 I.) PVP 17 2.5 Poloxamer 188 5 1:2 Water (pH 5.3) 80 0 0 70 66 H
H
I
PVP 17 1.25 Poloxamer 188 2.5 1:2 Water (pH 5.3) 70 53 47 0 (5) PVP 17 0.625 Poloxamer 188 1.25 1:2 Water (pH 5.4) 73 55 78 0 ko PVP 17 0.3125 Poloxamer 188 0.625 1:2 Water (pH 5.2) 64 62 78 PVP 17 0.5 Poloxamer 188 10 1:20 Water (pH 6.4) 79 0 0 58 59 PVP 17 0.25 Poloxamer 188 5 1:20 Water (pH 6.4) 82 0 0 62 0 PVP 17 55 Poloxamer 188 5.5 2:1 10mM
SC (pH 5.5) 86 39 0 78 82 PVP 17 40 Poloxamer 188 20 2:1 10mM
SC (pH 5.5) 86 41 0 88 94 1-d PVP 17 20 Poloxamer 188 10 2:1 10mM
SC (pH 5.5) 65 65 0 101 105 n ,-i PVP 17 20 Poloxamer 188 10 2:1 10mM
SC (pH 6.5) 87 0 0 97 102 PVP 17 20 Poloxamer 188 10 2:1 10mM
PP (pH 5.5) 71 0 0 79 79 cp w o PVP 17 20 Poloxamer 188 10 2:1 10mM
PP (pH 6.5) 65 0 0 63 65 o o PVP 17 40 Poloxamer 188 20 2:1 10 mM NaCI (pH 4.2) 104 0 0 96 104 'a o PVP 17 20 Poloxamer 188 10 2:1 10mM
NaCI (pH 4.4) 91 0 0 93 115 vi oe PVP 17 10 Poloxamer 188 20 1:2 Water (pH 5.2) 77 0 0 91 64 Ta bl e 4 Formulations using Botulinum Neurotoxin Complex' - Two Excipients with One Being a Non-Protein Polymer Excipient 1 Excipient 2 Recovered Potencyd (1)/0) 0t..) o Ambient Below Frerezing o Li t, Ratio Solutionc Temperatured Temperaturee .
'a Type Amount Type Amount Initial µ vD
o 12 3 12 o, --.1 months months months months --.1 PVP 17 20 Poloxamer 188 40 1:2 10mM
SC (pH 5.5) 92 39 0 83 96 PVP 17 10 Poloxamer 188 20 1:2 10mM
SC (pH 5.5) 81 71 49 97 85 PVP 17 2.5 Poloxamer 188 5 1:2 10mM
SC (pH 5.5) 104 76 73 PVP 17 1.25 Poloxamer 188 2.5 1:2 10mM
SC (pH 5.5) 72 92 90 PVP 17 0.625 Poloxamer 188 1.25 1:2 10mM SC (pH 5.5) 102 102 88 PVP 17 0.3125 Poloxamer 188 0.625 1:2 10mM SC (pH 5.5) 84 78 90 o PVP 17 10 Poloxamer 188 20 1:2 10mM
SC (pH 6.5) 88 0 0 79 91 0 I.) -,1 PVP 17 10 Poloxamer 188 20 1:2 10mM
PP (pH 5.5) 68 0 0 73 89 a, (5) PVP 17 10 Poloxamer 188 20 1:2 10mM
PP (pH 6.5) 88 0 0 88 88 a, I.) o in PVP 17 60 Poloxamer 188 3 20:1 10mM
HB (pH 5.5) 79 0 0 80 80 I.) PVP 17 55 Poloxamer 188 5.5 10:1 10mM
HB (pH 5.5) 92 0 0 0 0 H
H
I
PVP 17 40 Poloxamer 188 20 2:1 10mM
HB (pH 5.5) 72 0 0 92 92 0 (5) PVP 17 20 Poloxamer 188 40 1:2 10mM
HB (pH 5.5) 106 42 42 102 102 0 ko PVP 17 60 Poloxamer 188 3 20:1 10mM
HB (pH 6.5) 104 46 46 100 100 PVP 17 55 Poloxamer 188 5.5 10:1 10mM
HB (pH 6.5) 112 0 0 91 91 PVP 17 40 Poloxamer 188 20 2:1 10mM
HB (pH 6.5) 91 0 0 102 102 PVP 17 20 Poloxamer 188 40 1:2 10mM
HB (pH 6.5) 100 0 0 0 0 PVP 17 60 Poloxamer 188 3 20:1 10 mM NaCI (pH 3.0) 58 0 0 54 54 1-d PVP 17 30 Poloxamer 188 1.5 10:1 10mM NaCI (pH 3.0) 78 0 0 80 92 n ,-i PVP 17 55 Poloxamer 188 5.5 10:1 10 mM NaCI (pH 4.0) 68 0 0 92 92 PVP 17 27 Poloxamer 188 2.7 10:1 10 mM NaCI (pH 4.0) 76 0 0 88 83 cp w o PVP 17 48 Poloxamer 188 12 4:1 10 mM NaCI (pH 4.1) 92 82 82 o o PVP 17 24 Poloxamer 188 6 4:1 10 mM NaCI (pH 4.1) 102 0 0 78 79 'a o PVP 17 40 Poloxamer 188 20 2:1 10 mM NaCI (pH 4.3) 102 55 55 vi oe PVP 17 20 Poloxamer 188 10 2:1 10 mM NaCI (pH 4.3) 78 0 0 88 82 Ta bl e 4 Formulations using Botulinum Neurotoxin Complex' - Two Excipients with One Being a Non-Protein Polymer Excipient 1 Excipient 2 Recovered Potencyd (1)/0) 0t..) o Ambient Below Frerezing o Li t, Ratio Solutionc Temperatured Temperaturee .
'a Type Amount Type Amount Initial µ vD
o 12 3 12 o, --.1 rnonths months months months --.1 PVP 17 10 Poloxamer 188 20 1:2 10mM NaCI (pH 4.7) PVP 17 2.5 Poloxamer 188 5 1:2 10 mM NaCI (pH 5.2) PVP 17 1.25 Poloxamer 188 2.5 1:2 10mM NaCI (pH 5.2) PVP 17 0.625 Poloxamer 188 1.25 1:2 10 mM NaCI (pH 5.2) PVP 17 0.3125 Poloxamer 188 0.625 1:2 10mM NaCI (pH 5.2) PVP 17 10 Polysorbate 80 0.5 20:1 Water (pH 4.2) I.) -,1 PVP 17 5 Polysorbate 80 0.25 20:1 Water (pH 4.2) (5) PVP 17 10 Polysorbate 80 2.5 4:1 Water (pH 4.4) 90 I.) --.1 PVP 17 5 Polysorbate 80 1.25 4:1 Water (pH 4.4) 90 104 104 I.) H
H
I
PEG 3350 50 Mannitol 5 10:1 Water 0 (5) PEG 3350 50 Mannitol 50 1:1 Water 26 ko PEG 3350 5 Mannitol 50 1:10 Water 30 PEG 3350 60 Poloxamer 188 3 20:1 Water (pH 7.0) 0 PEG 3350 55 Poloxamer 188 5.5 10:1 Water (pH 7.0) 0 PEG 3350 50 Poloxamer 188 5 10:1 Water (pH 7.0) 0 PEG 3350 40 Poloxamer 188 20 2:1 Water (pH 7.0) 0 1-d PEG 3350 50 Poloxamer 188 50 1:1 Water 0 0 0 0 0 n ,-i PEG 3350 5 Poloxamer 188 50 1:10 Water 0 PEG 3350 60 Poloxamer 188 3 20:1 10mM SC (pH 5.5) 101 66 46 94 95 cp w o PEG 3350 55 Poloxamer 188 5.5 10:1 10mM SC (pH 5.5) 90 59 0 87 94 o o PEG 3350 40 Poloxamer 188 20 2:1 10mM SC (pH 5.5) 101 59 0 98 99 'a o --.1 PEG 3350 60 Poloxamer 188 3 20:1 10mM SC (pH 6.5) 70 0 0 58 70 vi oe PEG 3350 55 Poloxamer 188 5.5 10:1 10mM SC (pH 6.5) 'table t:
Formulations using Botulinum Neurotoxin Complex' ¨ Two Excipients with One Being a Non-Protein Polymer Excipient 1 Excipient 2 Recovered Potencyd (1)/0) 0 o Ambient Below Frerezing , o :_ Amount Ratio 13. Solutioe Temperatured Temperaturee Type Amount", :Type :
Initial .....................................................................

o o, --.1 :F.nonths months months month*: --.1 PEG 3350 40 Poloxamer 188 20 2:1 10mM SC (pH 6.5) PEG 3350 60 Poloxamer 188 3 20:1 10mM PP (pH 5.5) PEG 3350 55 Poloxamer 188 5.5 10:1 10mM PP (pH 5.5) PEG 3350 40 Poloxamer 188 20 2:1 10mM PP (pH 5.5) PEG 3350 60 Poloxamer 188 3 20:1 10mM PP (pH 6.5) PEG 3350 55 Poloxamer 188 5.5 10:1 10mM PP (pH 6.5) 0 0 0 0 0 o PEG 3350 40 Poloxamer 188 20 2:1 10mM PP (pH 6.5) I.) -,1 PEG 3350 60 Poloxamer 188 3 20:1 10mM HB (pH 5.5) (5) PEG 3350 55 Poloxamer 188 5.5 10:1 10mM HB (pH 5.5) I.) oe in PEG 3350 40 Poloxamer 188 20 2:1 10mM HB (pH 5.5) 72 82 65 83 89 I.) PEG 3350 60 Poloxamer 188 3 20:1 10mM HB (pH 6.5) H
I
PEG 3350 55 Poloxamer 188 5.5 10:1 10mM HB (pH 6.5) (5) i PEG 3350 40 Poloxamer 188 20 2:1 10mM HB (pH 6.5) ko PEG 3350 50 Glycine 5 10:1 Water 0 PEG 3350 50 Glycine 50 1:1 Water 0 PEG 3350 5 Glycine 50 1:10 Water 0 a Amount of botulinum neurotoxin serotype A complex added per formulation was 150 units. Total volume of formulation was 1.0 mL.
b For Sucrose, Lactose, Trehalose, Raffinose, Mannitol, !nulin, Detran 3K, Detran 40K, PEG 3550, PVP17, Poloxamer 188, and Glycine, the unit 1-d n amount of excipient added is in mg. For Polysorbate 20 and Polysorbate 80, the unit amount of excipient added is in mL.
cp c Buffer abbreviations are as follows: SC, sodium citrate buffer; PP potassium phosphate buffer; HB histidine buffer; HPB, histidine phosphate w o buffer.
o -a o d Recovery is expressed as a percentage and is calculated by dividing the potency of the active ingredient determined after reconstitution --4 vi divided by the potency of the active ingredient determined before addition to the formulation. 3 months refers to the length of time a formulation oe was minimally stored at the indicated temperature. 12 months refers to the length of time a formulation was minimally stored at the indicated Table 4 Formulations using Botulinum Neurotoxin Complexa - Two Excipients with One Being a Non-Protein Polymer Excipient 1 Excipient 2 Recovered Potencyd (%) 0 Ambient Below Frerezing b Ratio Solutione Temperatu red Temperaturee Amount Initial Amount Type Initial months months months months temperature.
e Ambient temperature is between about 18 C to about 22 C.
f Below freezing temperature is between about -5 C to about -20 C.

F') ) Ul ) A
[0145] Similar degrees of improved initial recovery and long-term stability was observed in Clostridial toxin pharmaceutical compositions comprising Dextran 40K and Poloxamer 188. For example, both Dextran 40K
and Poloxamer 188 alone resulted in no detectable recovered potency of a Clostridial toxin active ingredient (Table 2). Surprisingly Clostridial toxin pharmaceutical compositions comprising both Dextran 40K and Poloxamer 188 resulted in an initial recovered potency of the Clostridial toxin active ingredient of about 85%
to about 102% (Table 4). This synergistic effect was also observed in Clostridial toxin pharmaceutical compositions comprising Dextran 40K and Poloxamer 188 in buffered solutions.
Both Dextran 40K and Poloxamer 188 alone resulted in no detectable recovered potency of a Clostridial toxin active ingredient in formulations comprising potassium phosphate buffer (pH 6.5) (Table 2).
However, Clostridial toxin pharmaceutical compositions comprising Dextran 40K and Poloxamer 188 resulted in about 102% to about 115% initial recovered potency with the addition of potassium phosphate buffer (pH 6.5)(Table 4).
Furthermore, Clostridial toxin pharmaceutical compositions comprising Dextran 40K and Poloxamer 188 in various other buffered solutions resulted in enhanced recovered potency and long-term stability of the Clostridial toxin active ingredient. Thus, compositions comprising both Dextran 40K and Poloxamer 188 exhibited enhanced initial recovered potency in sodium citrate buffers (compare 81% initial recovered potency of Poloxamer 188 alone in sodium citrate buffer (pH 5.5)(Table 2) with 128%
initial recovered potency Dextran 40K and Poloxamer 188 together in sodium citrate buffer (pH 5.5)(Table 4); and 56% initial recovered potency of Poloxamer 188 alone in sodium citrate buffer (pH 5.5)(Table 2) with 100%
initial recovered potency Dextran 40K and Poloxamer 188 together in sodium citrate buffer (pH 6.5)(Table 4));
and potassium phosphate buffer (pH 5.5)(compare 39% initial recovered potency of Poloxamer 188 alone in potassium phosphate buffer (pH
5.5)(Table 2) with 103% initial recovered potency Dextran 40K and Poloxamer 188 together in potassium phosphate buffer (pH 5.5)(Table 4)).
[0146] Clostridial toxin pharmaceutical compositions comprising PVP 17 and a surfactant resulted in an effective increased recovered potency and long-term stability of the Clostridial toxin active ingredient over a wide range of excipient amounts. For example, when used as the sole excipient, PVP 17 was effective at increasing recovered potency at amounts ranging from about 5 mg to about 20 mg (about 0.5% (w/v) to about 2% (w/v)). As discussed above, Poloxamer 188 alone resulted in no detectable recovered potency of a Clostridial toxin active ingredient. However, about 0.3125 mg to about 2.5 mg of PVP 17 (about 0.03% (w/v) to about 0.25% (w/v)) in combination with from about 0.625 mg to about 5 mg of Poloxamer 188 (about 0.06%
(w/v) to about 0.5% (w/v)) increased recovered potency of the Clostridial toxin active ingredient to about 64%
to about 80% (each of these excipients at these concentrations alone resulted in no detectable recovery).
Similarly, about 30 mg to about 60 mg of PVP 17 (about 3% (w/v) to about 6%
(w/v)) in combination with from about 1.5 mg to about 5 mg of Poloxamer 188 (about 0.15% (w/v) to about 0.5%
(w/v)) increased recovered potency of the Clostridial toxin active ingredient to about 68% to about 77%
(each of these excipients at these concentrations alone resulted in no detectable recovery). The addition of various buffers or sodium chloride to Clostridial toxin pharmaceutical compositions comprising PVP 17and Poloxamer 188 did not appear to have a great affect on initial recovered potency or long-term stability of the Clostridial toxin active ingredient (Table 4).
[0147] Similar increased initial recovered potency of the Clostridial toxin active ingredient was observed with PVP 17 in combination with Polysorbate 80 (Table 4). Clostridial toxin compositions comprising about 5 mg to about 10 mg of PVP 17 (about 0.5% (w/v) to about 1% (w/V)) as the sole excipient resulted in about 48% to about 52 % recovered potency of a Clostridial toxin active ingredient (Table 2). However, Clostridial toxin compositions comprising about 5 mg to about 10 mg of PVP 17 (about 0.5% (w/v) to about 1% (w/V)) and about 0.25 mg to about 2.5 mg polysorbate 80 (about 0.025% (w/v) to about 0.25% (w/v)) resulted in an initial recovered potency of about 82% to about 90% (Table 4). The enhancement of long term stability was also observed in Clostridial toxin compositions comprising about sucrose and polysorbate 80 (see Table 4).
[0148] Clostridial toxin pharmaceutical compositions comprising PEG 3350 and a surfactant resulted in enhanced initial recovered potency and long-term stability of the Clostridial toxin active ingredient when formulated with certain buffered solutions. For example, both PEG 3350 alone and Poloxamer 188 alone resulted in no detectable recovered potency of a Clostridial toxin active ingredient (Table 2). Similarly, Clostridial toxin pharmaceutical compositions comprising PEG 3350 and Poloxamer 188 in water resulted in no detectable recovered potency of a Clostridial toxin active ingredient (Table 4). Surprisingly, however, Clostridial toxin pharmaceutical compositions comprising PEG 3350 and Poloxamer 188 in buffered formulations all resulted in effective recovered potency of the Clostridial toxin active ingredient, and in many cases resulted in enhanced initial recovery and long-term stability (Table 4).
For example, Clostridial toxin pharmaceutical compositions comprising about 60 mg PEG 3350 (about 6% (w/v)) in about pH 5.5 sodium citrate buffer resulted in an initial recovered potency of about 76%, whereas compositions comprising about 20 mg PEG 3350 (about 2% (w/v)) in about pH 5.5 sodium citrate buffer resulted in an initial recovered potency of about 81%. However, Clostridial toxin pharmaceutical compositions comprising about 40 mg to about 60 mg PEG 3350 (about 4% (w/v) to about 6% (w/v)) and about 3 mg to about 20 mg of Poloxamer 188 (about 0.3% (w/v) to about 2% (w/v)) in about pH 5.5 sodium citrate buffer resulted in an initial recovered potencies of about 90% to about 101%. Long term stability of the Clostridial toxin active ingredient was also enhanced in these formulations (Table 4).
[0149] Similarly, Clostridial toxin pharmaceutical compositions comprising about 60 mg PEG 3350 (about 6%
(w/v)) in about pH 6.5 sodium citrate buffer resulted in an initial recovered potency of about 57%, whereas compositions comprising about 20 mg PEG 3350 (about 2% (w/v)) in about pH 6.5 sodium citrate buffer resulted in an initial recovered potency of about 80%. However, Clostridial toxin pharmaceutical compositions comprising about 40 mg to about 60 mg PEG 3350 (about 4% (w/v) to about 6%
(w/v)) and about 3 mg to about 20 mg of Poloxamer 188 (about 0.3% (w/v) to about 2% (w/v)) in about pH
6.5 sodium citrate buffer resulted in an initial recovered potencies of about 83% to about 98%. Long term stability of the Clostridial toxin active ingredient was also enhanced in these formulations (Table 4).

'tablet"
Formulations using Botulinum Neurotoxin Complex' ¨ Two Excipients with One Being a Surfactant Excipient 1 Excipient 2 Recovered Potencyd (1)/0) 0 o Ambient Below Frerezing o 6:: Ratio Solution e : Temperature Temperaturef Type Amountbi Type Amount :::
Initial .................................................................

12 µ
3 12 vD
o o, --.1 months months months months:
--.1 Poloxamer 188 50 Mannitol 5 10:1 Water 30 ¨
¨ ¨ ¨
Poloxamer 188 50 Mannitol 50 1:1 Water 33 ¨
¨ ¨ ¨
Poloxamer 188 5 Mannitol 50 1:10 Water 35 ¨
¨ ¨ ¨
Poloxamer 188 50 Glycine 5 10:1 Water 33 ¨
¨ ¨ ¨
Poloxamer 188 50 Glycine 50 1:1 Water 26 ¨
¨ ¨ ¨
Poloxamer 188 5 Glycine 50 1:10 Water 0 0 0 0 0 n a Amount of botulinum neurotoxin serotype A complex added per formulation was
150 units. Total volume of formulation was 1.0 mL. 0 I.) -,1 FP

b For Sucrose, Lactose, Trehalose, Raffinose, Mannitol, !nulin, Detran 3K, Detran 40K, PEG 3550, PVP17, Poloxamer 188, and Glycine, the unit I.) amount of excipient added is in mg. For Polysorbate 20 and Polysorbate 80, the unit amount of excipient added is in mL. in I.) c Buffer abbreviations are as follows: SC, sodium citrate buffer; PP potassium phosphate buffer; HB histidine buffer; HPB, histidine phosphate H
H
I
buffer.

(5) i d Recovery is expressed as a percentage and is calculated by dividing the potency of the active ingredient determined after reconstitution ko divided by the potency of the active ingredient determined before addition to the formulation. 3 months refers to the length of time a formulation was minimally stored at the indicated temperature. 12 months refers to the length of time a formulation was minimally stored at the indicated temperature.
e Ambient temperature is between about 18 C to about 22 C.
1-d f Below freezing temperature is between about -5 C to about -20 C.
n ,-i cp t.., =
=
-a c., u, oe [0150] Clostridial toxin pharmaceutical compositions comprising a polyol and a surfactant also resulted in recovered potency of the Clostridial toxin active ingredient. For example, both mannitol alone and Poloxamer 188 alone resulted in no detectable recovered potency of a Clostridial toxin active ingredient (Table 2).
Surprisingly Clostridial toxin pharmaceutical compositions comprising mannitol and Poloxamer 188 resulted in recovered potency of the Clostridial toxin active ingredient (Table 5).
[0151] Clostridial toxin pharmaceutical compositions comprising an amino acid and a surfactant also resulted in recovered potency of the Clostridial toxin active ingredient. For example, both glycine alone and Poloxamer 188 alone resulted in no detectable recovered potency of a Clostridial toxin active ingredient (Table 2). Surprisingly Clostridial toxin pharmaceutical compositions comprising glycine and Poloxamer 188 resulted in recovered potency of about 30% to about 35% of the Clostridial toxin active ingredient (Table 5).
Example 3 Non-Protein Stabilized Formulations - Three Excipients
[0152] Experiments were carried out to determine the effects of formulations comprising three different non-protein excipients on Clostridial toxin active ingredient recovery after reconstitution. The non-protein excipients tested were added separately or in combination with the listed buffers or salts (Table 6). All of the formulations were compounded, lyophilized, reconstituted and potency assessed in the same manner, and with the same Clostridial toxin active ingredient used in each formulation, except that each formulation was prepared with different non-protein excipients or with different amounts of the non-protein excipients.
[0153] The tested formulations were compounded, processed, stored and reconstituted as described in Example 1. Recovered potency was determined using the mouse LD50 bioassay described in Example 1.
Recovery is expressed as a percentage and is calculated by dividing the potency of the Clostridial toxin active ingredient in the stored reconstitution formulation by the potency of the active Clostridial toxin ingredient determined prior to its addition into the test solution. The results show that a Clostridial toxin pharmaceutical composition comprising a Clostridial toxin complex could be stabilized when the formulation comprised three non-protein excipients (Table 6).
[0154] Clostridial toxin pharmaceutical compositions comprising a sugar, a non-protein polymer and a surfactant resulted in an effective recovered potency and long-term stability of the Clostridial toxin active ingredient. For example, Clostridial toxin pharmaceutical compositions comprising about 10 mg sucrose (1%
(w/v)) and about 10 mg PVP 17 (1% (w/v)) exhibited an initial recovered potency of the Clostridial toxin active ingredient of about 77% (Table 4). Likewise, Clostridial toxin pharmaceutical compositions comprising about mg sucrose (about 1% (w/v)) and about 10 mg Poloxamer 188 (about 1% (w/v)) exhibited an initial recovered potency of the Clostridial toxin active ingredient of about 59%
(Table 4). Similarly, Clostridial toxin pharmaceutical compositions comprising about 10 mg to about 20 mg of Kollodon 17 (about 1% (w/v) to about 2% (w/v)) and about 10 mg to about 20 mg Poloxamer 188 (about 1% (w/v) to about 2% (w/v)) exhibited an initial recovered potency of the Clostridial toxin active ingredient of about 71% to about 82% (Table 4).

However, Clostridial toxin pharmaceutical compositions comprising about 10 mg sucrose (about 1% (w/v)), about 10 mg PVP 17 (about 1% (w/v)), and about 10 mg Poloxamer 188 (about 1%
(w/v)), exhibited a recovered potency of the Clostridial toxin active ingredient of about 102%
(Table 6). A similar increase in initial recovered potency, of about 89%, was observed in Clostridial toxin pharmaceutical compositions comprising about 15 mg sucrose (about 1.5% (w/v)), about 30 mg PVP 17 (about 3% (w/v)), and about 15 mg Poloxamer 188 (about 1.5% (w/v))(Table 6). The addition of various buffers or sodium chloride to Clostridial toxin pharmaceutical compositions comprising sucrose, PVP 17 and Poloxamer 188 enhanced initial recovered potency or long-term stability of the Clostridial toxin active ingredient , depending on the amounts of each excipient added (Table 6).
[0155] Clostridial toxin pharmaceutical compositions comprising two different sugars and a surfactant resulted in an effective recovered potency and long-term stability of the Clostridial toxin active ingredient. For example, compositions comprising sucrose, lactose and Poloxamer 188 resulted in initial recovered potency of about 81% to about 114% (Table 6). Surprisingly, Clostridial toxin pharmaceutical compositions comprising sucrose, lactose and Poloxamer 188 enhanced initial recovered potency with the addition of about pH 6.5 sodium citrate buffer. For example, Clostridial toxin pharmaceutical compositions comprising about 20 mg sucrose (about 2% (w/v)) and about 20 mg lactose (about 2% (w/v)) in about pH
6.5 sodium citrate buffer resulted in 41% initial recovered potency (Table 3). Likewise, Clostridial toxin pharmaceutical compositions comprising about 20 mg sucrose (about 2% (w/v)) and about 10 mg Poloxamer 188 (about 1% (w/v)) in about pH 6.5 sodium citrate buffer resulted in 90% initial recovered potency (Table 3). Similarly, Clostridial toxin pharmaceutical compositions comprising about 20 mg lactose (about 2% (w/v)) and about 10 mg Poloxamer 188 (about 1% (w/v)) in about pH 6.5 sodium citrate buffer resulted in 81%
initial recovered potency (Table 3). However, compositions comprising all three excipients in about pH 6.5 sodium citrate buffer resulted in about 99% initial recovered potency (Table 6).
[0156] Clostridial toxin pharmaceutical compositions comprising a sugar and two different non-protein polymers resulted in enhanced recovered potency and long-term stability of the Clostridial toxin active ingredient. For example, Clostridial toxin pharmaceutical compositions comprising about 5 mg to about 20 mg of sucrose (about 0.5% (w/v) to about 2% (w/v)) and about 5 mg to about 15 mg PVP 17 (about 0.5% (w/v) to about 1.5% (w/v)) resulted in initial recovered potency of about 58% to about 77% (Table 3). Likewise, Clostridial toxin pharmaceutical compositions comprising about 5 mg to about 50 mg of sucrose (about 0.5%
(w/v) to about 5% (w/v)) and about 5 mg to about 50 mg PEG 3350 (about 0.5%
(w/v) to about 5% (w/v)) resulted in initial recovered potency of about 35% to about 44% (Table 3).
Similarly, Clostridial toxin pharmaceutical compositions comprising about 30 mg to about 40 mg of PVP 17 (about 3% (w/v) to about 4%
(w/v)) and about 20 mg to about 30 mg PEG 3350 (about 2% (w/v) to about 2%
(w/v)) resulted in initial recovered potency of about 80% (Table 4). However, compositions comprising all three excipients resulted in about 82% to about 102% initial recovered potency (Table 6).

Table 6 Formulations using Botulinum Neurotoxin Complex' - Three Excipients Excipient 1 Excipient 2 Excipient 3 Recovered Potencya ___________ (%)0t..) o Ambient Below Frerezi9g 18 b b Ratio Solution' Temperature Temperature' Type Amount Type Amountb Type Amount Initial µ
. ________________ vD
o 3 12 3 12 o, months months months months Sucrose 30 PVP 17 30 Poloxamer 188 3 10:10:1 Water (pH 4.2) 75 79 62 Sucrose 15 PVP 17 15 Poloxamer 188 1.5 10:10:1 Water (pH 4.6) 82 0 0 70 70 Sucrose 27.5 PVP 17 27.5 Poloxamer 188 5.5 5:5:1 Water (pH 4.2) 66 0 0 65 65 Sucrose 13.5 PVP 17 13.5 Poloxamer 188 2.7 5:5:1 Water (pH 4.2) 82 0 0 76 76 Sucrose 20 PVP 17 10 Poloxamer 188 5 4:2.1 Water (pH 4.5) 104 59 55 110 113 Sucrose 20 PVP 17 20 Poloxamer 188 10 2:2:1 Water (pH 4.4) 102 49 0 96 103 o Sucrose 24 PVP 17 24 Poloxamer 188 12 2:2:1 Water (pH 4.4) 88 0 0 62 61 0 I.) -,1 Sucrose 12 PVP 17 12 Poloxamer 188 6 2:2:1 Water (pH 4.4) 88 0 0 65 80 (5) oe Sucrose 30 PVP 17 15 Poloxamer 188 15 2:1:1 Water (pH 4.3) 80 0 0 115 91 I.) vi in Sucrose 15 PVP 17 30 Poloxamer 188 15 1:2:1 Water (pH 4.3) 89 84 88 I.) Sucrose 20 PVP 17 20 Poloxamer 188 20 1:1:1 Water (pH 4.6) 81 0 0 81 85 H
H
I
Sucrose 10 PVP 17 10 Poloxamer 188 10 1:1:1 Water (pH 4.6) 102 46 0 79 92 0 (5) Sucrose 12 PVP 17 24 Poloxamer 188 24 1:2:2 Water (pH 4.8) 104 0 0 82 92 0 ko Sucrose 10 PVP 17 20 Poloxamer 188 30 1:2:3 Water (pH 5.0) 97 49 0 102 95 Sucrose 20 PVP 17 10 Poloxamer 188 5 4:2:1 10mM SC (pH 5.5) 83 51 49 73 89 Sucrose 20 PVP 17 10 Poloxamer 188 5 4:2:1 10mM SC (pH 6.5) 101 52 41 101 103 Sucrose 20 PVP 17 10 Poloxamer 188 5 4:2:1 10mM PP (pH 5.5) 85 68 41 115 101 Sucrose 20 PVP 17 10 Poloxamer 188 5 4:2:1 10mM PP (pH 6.5) 89 69 38 103 101 1-d Sucrose 20 PVP 17 20 Poloxamer 188 10 2:2:1 10mM SC (pH 5.5) 83 51 0 97 91 n ,-i Sucrose 20 PVP 17 20 Poloxamer 188 10 2:2:1 10mM SC (pH 6.5) 100 0 0 87 113 Sucrose 20 PVP 17 20 Poloxamer 188 10 2:2:1 10mM PP (pH 5.5) 93 58 41 110 99 cp w o Sucrose 20 PVP 17 20 Poloxamer 188 10 2:2:1 10mM PP (pH 6.5) 63 55 0 57 89 o vD
'a Sucrose 15 PVP 17 30 Poloxamer 188 15 1:2:1 10mM SC (pH 5.5) 106 58 0 103 101 o, --.1 Sucrose 20 PVP 17 20 Poloxamer 188 20 1:1:1 10mM SC (pH 5.5) 96 95 91 vi c.,.) oe Sucrose 12 PVP 17 24 Poloxamer 188 24 1:2:2 10mM SC (pH 5.5) 104 65 0 100 105 Table 6 Formulations using Botulinum Neurotoxin Complex' - Three Excipients Excipient 1 Excipient 2 Excipient 3 Recovered Potencya ___________ (%)0t..) o Ambient Below Frerezing 18 b b Ratio Solution' Temperature Temperature Type Amount Type Amountb Type Amount Initial µ
. ________________ vD
o 3 12 3 12 o, months months months months Sucrose 10 PVP 17 20 Poloxamer 188 30 1:2:3 10mM SC (pH 5.5) 108 63 0 107 96 Sucrose 14 PVP 17 14 Poloxamer 188 1.4 10:10:1 10 mM NaCI (pH 4.1) 92 0 0 88 75 Sucrose 27.5 PVP 17 27.5 Poloxamer 188 5.5 5:5:1 10 mM NaCI (pH 4.2) 92 0 0 75 75 Sucrose 13.75 PVP 17 13.75 Poloxamer 188 2.75 5:5:1 10 mM NaCI (pH 4.2) 88 0 0 78 92 Sucrose 20 PVP 17 10 Poloxamer 188 5 4:2:1 10mM NaCI (pH 4.5) 107 59 51 115 113 Sucrose 20 PVP 17 20 Poloxamer 188 10 2:2:1 10mM NaCI (pH 4.4) 103 49 0 103 117 o Sucrose 24 PVP 17 24 Poloxamer 188 12 2:2:1 10 mM NaCI (pH 4.3) 82 0 0 85 72 0 I.) -,1 Sucrose 12 PVP 17 12 Poloxamer 188 6 2:2:1 10 mM NaCI (pH 4.4) 80 0 0 75 84 (5) Sucrose 20 PVP 17 20 Poloxamer 188 20 1:1:1 10mM NaCI (pH 4.5) 82 0 0 92 92 I.) oe o, in Sucrose 10 PVP 17 10 Poloxamer 188 10 1:1:1 10 mM NaCI (pH 4.6) 92 50 52 83 92 I.) H
H
I
Sucrose 20 Lactose 20 Poloxamer 188 10 2:2:1 Water (pH 5.5) 89 84 67 102 108 0 (5) Sucrose 20 Lactose 20 Poloxamer 188 10 2:2:1 10mM SC (pH 5.5) 88 85 67 87 91 0 ko Sucrose 20 Lactose 20 Poloxamer 188 10 2:2:1 10mM SC (pH 6.5) 99 65 65 77 117 Sucrose 20 Lactose 20 Poloxamer 188 10 2:2:1 10mM PP (pH 5.5) 114 87 73 115 115 Sucrose 20 Lactose 20 Poloxamer 188 10 2:2:1 10mM PP (pH 6.5) 89 101 58 101 114 Sucrose 20 Lactose 20 Poloxamer 188 10 2:2:1 10mM NaCI (pH 5.4) 81 101 65 115 101 1-d Sucrose 25 Glycine 25 Poloxamer 188 5 5:5:1 Water (pH 6.1) 93 82 82 80 80 n ,-i Sucrose 13.75 Glycine 13.75 Poloxamer 188 2.75 5:5:1 Water (pH 6.1) 92 95 95 cp w o Sucrose 10 PVP 17 10 PEG 3350 10 1:1:1 Water (pH 4.9) 88 53 53 72 72 o vD
Sucrose 5 PVP 17 5 PEG 3350 5 1:1:1 Water (pH 4.9) 102 61 46 82 82 'a o, --.1 Sucrose 10 PVP 17 20 PEG 3350 10 1:2:1 Water (pH 4.6) 92 0 0 62 62 vi oe Sucrose 5 PVP 17 10 PEG 3350 5 1:2:1 Water (pH 4.6) 96 61 0 100 80 Table 6 Formulations using Botulinum Neurotoxin Complex' ¨ Three Excipients Excipient 1 Excipient 2 Excipient 3 Recovered Potencya (1)/0) 0t..) o Ambient Below Frerezing 18 b b Ratio Solution' Temperature Temperature Type Amount Type Amountb Type Amount Initial µ
. ______________ vD
o 3 12 3 12 o, months months months months Sucrose 2.5 PVP 17 5 PEG 3350 2.5 1:2:1 Water (pH 5.0) 82 0 0 82 82 Lactose 40 PEG 3550 10 Poloxamer 188 10 4:1:1 Water (pH 5.6) 91 59 0 110 102 Lactose 40 PEG 3550 10 Poloxamer 188 10 4:1:1 10mM SC (pH 5.5) 95 60 64 104 95 Trehalose 15 PEG 3550 45 Polysorbate 20 0.1 150:450:1 50 mM HPB (pH 6.5) 158 100 85 85 o Trehalose 20 PEG 3550 40 Polysorbate 20 0.1 200:400:1 50 mM HPB (pH 6.5) 161 66 98 98 0 I.) -,1 5) a, Trehalose 20 PEG 3550 40 Polysorbate 20 0.1 200:400:1 50 mM HPB (pH 6. 161 100100 100 (5) 3.3 mM NaCI
a, oe I.) I.) Dextran 3K 30 PEG 3550 30 Poloxamer 188 3 10:10:1 Water (pH 6.6) 82 0 0 82 92 0 H
H
I
Dextran 3K 50 PEG 3550 5 Poloxamer 188 5 5:1:1 Water (pH 6.2) 90 0 0 75 82 0 (5) Dextran 3K 5 PEG 3550 50 Poloxamer 188 5 1:5:1 Water (pH 6.9) 81 0 0 62 62 1 Dextran 3K 20 PEG 3550 20 Poloxamer 188 20 1:1:1 Water (pH 6.8) 104 0 0 0 0 ko Dextran 3K 30 PEG 3550 30 Poloxamer 188 3 10:10:1 10mM SC (pH 5.5) 102 0 0 67 104 Dextran 3K 50 PEG 3550 5 Poloxamer 188 5 5:1:1 10mM SC (pH 5.5) 92 0 0 92 92 Dextran 3K 5 PEG 3550 50 Poloxamer 188 5 1:5:1 10mM SC (pH 5.5) 88 0 0 88 80 Dextran 3K 20 PEG 3550 20 Poloxamer 188 20 1:1:1 10mM SC (pH 5.5) 106 0 0 82 92 Dextran 3K 30 PEG 3550 30 Poloxamer 188 3 10:10:1 10mM SC (pH 6.5) 79 0 0 88 88 1-d n Dextran 3K 50 PEG 3550 5 Poloxamer 188 5 5:1:1 10mM SC (pH 6.5) 96 0 0 88 98 Dextran 3K 5 PEG 3550 50 Poloxamer 188 5 1:5:1 10mM SC (pH 6.5) 76 0 0 92 92 cp w o Dextran 3K 20 PEG 3550 20 Poloxamer 188 20 1:1:1 10mM SC (pH 6.5) 95 0 0 102 87 =
o Dextran 3K 30 PEG 3550 30 Poloxamer 188 3 10:10:1 10mM PP (pH 5.5) 92 0 0 104 82 'a o Dextran 3K 50 PEG 3550 5 Poloxamer 188 5 5:1:1 10mM PP (pH 5.5) 92 0 0 96 82 vi oe Dextran 3K 5 PEG 3550 50 Poloxamer 188 5 1:5:1 10mM PP (pH 5.5) 96 0 0 82 104 Table 6 Formulations using Botulinum Neurotoxin Complex' - Three Excipients Excipient 1 Excipient 2 Excipient 3 Recovered Potencya ___________ (%)0t..) o Ambient Below Frerezi9g 18 b b Ratio Solution' Temperature Temperature' Type Amount Type Amountb Type Amount Initial µ
. ________________ vD
o 3 12 3 12 o, months months months months Dextran 3K 20 PEG 3550 20 Poloxamer 188 20 1:1:1 10mM PP (pH 5.5) 87 0 0 92 104 Dextran 3K 30 PEG 3550 30 Poloxamer 188 3 10:10:1 10mM PP (pH 6.5) 96 0 0 96 88 Dextran 3K 50 PEG 3550 5 Poloxamer 188 5 5:1:1 10mM PP (pH 6.5) 100 0 0 104 102 Dextran 3K 5 PEG 3550 50 Poloxamer 188 5 1:5:1 10mM PP (pH 6.5) 106 0 0 98 82 Dextran 3K 20 PEG 3550 20 Poloxamer 188 20 1:1:1 10mM PP (pH 6.5) 82 0 0 106 104 Dextran 3K 30 PEG 3550 30 Poloxamer 188 3 10:10:1 10mM HB (pH 5.5) 70 0 0 92 0 o Dextran 3K 50 PEG 3550 5 Poloxamer 188 5 5:1:1 10mM HB (pH 5.5) 90 53 0 86 102 0 I.) -,1 Dextran 3K 5 PEG 3550 50 Poloxamer 188 5 1:5:1 10mM HB (pH 5.5) 102 46 0 82 76 (5) Dextran 3K 20 PEG 3550 20 Poloxamer 188 20 1:1:1 10mM HB (pH 5.5) 75 46 0 92 68 I.) oe oe in Dextran 3K 30 PEG 3550 30 Poloxamer 188 3 10:10:1 10mM HB (pH 6.5) 87 0 0 102 86 I.) Dextran 3K 50 PEG 3550 5 Poloxamer 188 5 5:1:1 10mM HB (pH 6.5) 92 0 0 84 90 H
H
I
Dextran 3K 5 PEG 3550 50 Poloxamer 188 5 1:5:1 10mM HB (pH 6.5) 102 0 0 106 61 0 (5) Dextran 3K 20 PEG 3550 20 Poloxamer 188 20 1:1:1 10mM HB (pH 6.5) 65 0 0 96 78 0 l0 PVP 17 30 PEG 3550 30 Poloxamer 188 3 10:10:1 Water (pH 5.1) 66 0 0 58 58 PVP 17 50 PEG 3550 5 Poloxamer 188 5 5:1:1 Water (pH 4.2) 82 0 0 70 70 PVP 17 5 PEG 3550 50 Poloxamer 188 5 1:5:1 Water (pH 6.6) 0 0 0 0 0 PVP 17 20 PEG 3550 20 Poloxamer 188 20 1:1:1 Water (pH 5.4) 78 0 0 66 66 1-d PVP 17 30 PEG 3550 30 Poloxamer 188 3 10:10:1 10mM SC (pH 5.5) 82 0 0 62 62 n ,-i PVP 17 50 PEG 3550 5 Poloxamer 188 5 5:1:1 10mM SC (pH 5.5) 88 0 0 78 78 PVP 17 5 PEG 3550 50 Poloxamer 188 5 1:5:1 10mM SC (pH 5.5) 96 0 0 96 96 cp w o PVP 17 20 PEG 3550 20 Poloxamer 188 20 1:1:1 10mM SC (pH 5.5) 82 0 0 100 100 o vD
'a PVP 17 30 PEG 3550 30 Poloxamer 188 3 10:10:1 10mM SC (pH 6.5) ¨ o, --.1 PVP 17 50 PEG 3550 5 Poloxamer 188 5 5:1:1 10mM SC (pH 6.5) ¨ vi oe PVP 17 5 PEG 3550 50 Poloxamer 188 5 1:5:1 10mM SC (pH 6.5) ¨

Table 6 Formulations using Botulinum Neurotoxin Complex' - Three Excipients Excipient 1 Excipient 2 Excipient 3 Recovered Potency (%) Ambient Below Frerezi9g 18 izi:: :::
Solutioe Temperature Temperature' 'a Type ::Amount Type Amount Type ::Amountb Ratio Initial 3 12 3 12 o, months months months months:
PVP 17 20 PEG 3550 20 Poloxamer 188 20 1:1:1 10mM SC (pH 6.5) ¨ ¨ ¨ ¨ ¨
PVP 17 30 PEG 3550 30 Poloxamer 188 3 10:10:1 10mM PP (pH 5.5) ¨ ¨ ¨ ¨ ¨
PVP 17 50 PEG 3550 5 Poloxamer 188 5 5:1:1 10mM PP (pH 5.5) ¨ ¨ ¨ ¨ ¨
PVP 17 5 PEG 3550 50 Poloxamer 188 5 1:5:1 10mM PP (pH 5.5) ¨ ¨ ¨ ¨ ¨
PVP 17 20 PEG 3550 20 Poloxamer 188 20 1:1:1 10mM PP (pH 5.5) ¨ ¨ ¨ ¨ ¨
PVP 17 30 PEG 3550 30 Poloxamer 188 3 10:10:1 10mM PP (pH 6.5) ¨ ¨ ¨ ¨ ¨ o PVP 17 50 PEG 3550 5 Poloxamer 188 5 5:1:1 10mM PP (pH 6.5) ¨ ¨ ¨ _ _ 0 I.) PVP 17 5 PEG 3550 50 Poloxamer 188 5 1:5:1 10mM PP (pH 6.5) ¨ ¨ ¨ ¨ ¨
FP

PVP 17 20 PEG 3550 20 Poloxamer 188 20 1:1:1 10mM PP (pH 6.5) ¨ ¨ ¨ ¨ ¨
I.) oe o in PVP 17 30 PEG 3550 30 Poloxamer 188 3 10:10:1 10mM HB (pH 5.5) 78 0 0 54 54 I.) PVP 17 50 PEG 3550 5 Poloxamer 188 5 5:1:1 10mM HB (pH 5.5) 92 0 0 88 88 H
H
PVP 17 5 PEG 3550 50 Poloxamer 188 5 1:5:1 10mM HB (pH 5.5) 106 70 70 82 82 i (5) PVP 17 20 PEG 3550 20 Poloxamer 188 20 1:1:1 10mM HB (pH 5.5) 102 0 0 64 64 i ko PVP 17 30 PEG 3550 30 Poloxamer 188 3 10:10:1 10mM HB (pH 6.5) 95 0 0 92 92 PVP 17 50 PEG 3550 5 Poloxamer 188 5 5:1:1 10mM HB (pH 6.5) 106 50 50 96 96 PVP 17 5 PEG 3550 50 Poloxamer 188 5 1:5:1 10mM HB (pH 6.5) 104 46 46 91 91 PVP 17 20 PEG 3550 20 Poloxamer 188 20 1:1:1 10mM HB (pH 6.5) 110 53 53 104 104 1-d PVP 17 25 Glycine 25 Poloxamer 188 5 5:5:1 Water (pH 5.6) 79 0 0 78 78 n ,-i PVP 17 13.75 Glycine 13.75 Poloxamer 188 2.75 5:5:1 Water (pH 5.6) 83 ¨ ¨ 62 63 cp a Amount of botulinum neurotoxin serotype A complex added per formulation was 150 units. Total volume of formulation was 1.0 mL. w o =
o b For Sucrose, Lactose, Trehalose, Raffinose, Mannitol, Inulin, Detran 3K, Detran 40K, PEG 3550, PVP17, Poloxamer 188, and Glycine, the unit amount of excipient added is is in mg. For Polysorbate 20 and Polysorbate 80, the unit amount of excipient added is in mL. --.1 vi c.,.) oe c Buffer abbreviations are as follows: SC, sodium citrate buffer; PP potassium phosphate buffer; HB histidine buffer; HPB, histidine phosphate buffer.

Table 6 Formulations using Botulinum Neurotoxin Complexa ¨ Three Excipients Excipient 1 Excipient 2 Excipient 3 Recovered Potencyd (%) 0 Ambient Below Frerezing Ratio Solution Temperature Temperaturef Type Amount b Type Amount b Type Amountb Initial months months months months -4 d Recovery is expressed as a percentage and is calculated by dividing the potency of the active ingredient determined after reconstitution divided by the potency of the active ingredient determined before addition to the formulation. 3 months refers to the length of time a formulation was minimally stored at the indicated temperature. 12 months refers to the length of time a formulation was minimally stored at the indicated temperature.
e Ambient temperature is between about 18 C to about 22 C.
f Below freezing temperature is between about -5 C to about -20 C. 0 Ul A
[0157] Clostridial toxin pharmaceutical compositions comprising two different non-protein polymers and a surfactant resulted in an effective recovered potency and long-term stability of the Clostridial toxin active ingredient. For example, Clostridial toxin pharmaceutical compositions comprising Dextran 3K, PEG 3350 and Poloxamer 188 resulted in initial recovered potencies of about 81% to about 104% when in water, about 88% to about 106% when in about pH 5.5 sodium citrate buffer, about 76% to about 96% when in about pH
6.5 sodium citrate buffer, about 87% to about 96% when in about pH 6.5 potassium phosphate buffer, about 82% to about 106% when in about pH 6.5 potassium phosphate buffer, about 70%
to about 102% when in about pH 5.5 histidine buffer, and about 65% to about 102% when in about pH
6.5 histidine buffer (Table 6).
Similarly, Clostridial toxin pharmaceutical compositions comprising PVP 17, PEG 3350 and Poloxamer 188 resulted in an effective recovered potency and long-term stability of the Clostridial toxin active ingredient (Table 6).
Example 4 Non-Protein Stabilized Formulations ¨ 150 kDa Clostridia! Toxin
[0158] Experiments were carried out to prepare multiple formulations where the Clostridial toxin active ingredient contained in the formulations was a 150-kDa Clostridia! toxin (Table 7). The non-protein excipients tested were added separately or in combination with the listed buffers or salts (Table 7). All of the formulations were compounded, lyophilized, reconstituted and potency assessed in the same manner, and with the same Clostridial toxin active ingredient used in each formulation, except that each formulation was prepared with different non-protein excipients or with different amounts of the non-protein excipients.
[0159] The tested formulations were compounded, processed, stored and reconstituted as described in Example 1, except that the Clostridial toxin active ingredient added was about 150 units of a 150 kDa BoNT/A. Recovered potency was determined using the mouse LD50 bioassay described in Example 1.
Recovery is expressed as a percentage and is calculated by dividing the potency of the Clostridial toxin active ingredient in the stored reconstitution formulation by the potency of the active Clostridial toxin ingredient determined prior to its addition into the test solution. The results show that a Clostridial toxin pharmaceutical composition comprising a 150-kDa Clostridial toxin could be stabilized when the formulation comprised two or more non-protein excipients (Table 7).
[0160] Clostridial toxin pharmaceutical compositions comprising a sugar and a surfactant resulted in an effective initial recovered potency of the Clostridial toxin active ingredient. For example, both sucrose alone and Poloxamer 188 alone resulted in no detectable recovered potency of a Clostridial toxin active ingredient (Table 7). Surprisingly Clostridial toxin pharmaceutical compositions comprising sucrose in combination with Poloxamer 188 resulted in recovered potency of the Clostridial toxin active ingredient of about 113% (Table 7). These findings regarding 150 kDa BoNT/A are similar to the synergistic recovery observed with the 900-kDa BoNT/A toxin complex in Examples 1-3, where Clostridial toxin pharmaceutical compositions comprising sucrose in combination with Poloxamer 188 resulted in 99% initial recovered potency (Table 3).
[0161] Clostridia! toxin pharmaceutical compositions comprising lactose and/or Poloxamer 188 yielded mixed results as those seen with the 900-Kda BoNT/A toxin complex in Examples 1-3.
For example, pharmaceutical compositions comprising lactose as the sole excipient did not result in any detectable recovered potency of the Clostridial toxin active ingredient (150 kDa BoNT/A)(Table 7). This lack of recovery was unexpected given the finding of recovered potency of about 35% for pharmaceutical compositions comprising lactose as the sole excipient when the Clostridial toxin active ingredient was the 900-kDa BoNT/A toxin complex (Table 2).
Clostridial toxin pharmaceutical compositions comprising Poloxamer 188 as the sole excipient resulted in no detectable recovered potency of a Clostridial toxin active ingredient (Table 7), a finding similar to those discussed in Example 1. More strikingly, Clostridial toxin pharmaceutical compositions comprising lactose and Poloxamer 188 as excipients resulted in an initial recovered potency of about 110% (Table 7). Thus, like the 900-kDa BoNT/A toxin complex, there is a synergistic recovery of the 150 kDa BoNT/A in pharmaceutical compositions comprising lactose and Poloxamer 188.
[0162] Clostridial toxin pharmaceutical compositions comprising two non-protein polymers also resulted in an effective initial recovered potency of the Clostridial toxin active ingredient. For example, Clostridial toxin pharmaceutical compositions comprising Dextran 40K and/or Poloxamer 188 also yielded comparable results as those seen with the 900-kDa BoNT/A toxin complex in Examples 1-3. For example, recovery of the 150 kDa BoNT/A was observed in pharmaceutical compositions comprising Dextran 40K
and Poloxamer 188, although the initial recovered potency was lower for the 150 kDa BoNT/A
(compare about 50% initial recovered potency of the 150 kDa BoNT/A in Table 7 versus about 85% initial recovered potency of the 900-kDa BoNT/A toxin complex in Table 4).
[0163] Clostridial toxin pharmaceutical compositions comprising PEG 3350 and/or Poloxamer 188 yielded somewhat different results as those seen with the 900-kDa BoNT/A toxin complex in Examples 1-3. For example, initial recovery potency of about 47% of the 150 kDa BoNT/A was observed in pharmaceutical compositions comprising PEG 3350 and Poloxamer 188 (Table 7). This recovery was unexpected given the finding that no recovered potency was detected for pharmaceutical compositions comprising PEG 3350 and Poloxamer 188 when the Clostridial toxin active ingredient was the 900-kDa BoNT/A toxin complex (Table 4).
However, Clostridial toxin pharmaceutical compositions comprising PEG 3350 and/or Poloxamer 188 in about pH 5.5 sodium citrate buffer yielded comparable results as those seen with the 900-kDa BoNT/A toxin complex in Examples 1-3. For example, recovery of the 150 kDa BoNT/A was observed in pharmaceutical compositions comprising PEG 3350 and/or Poloxamer 188 in about pH 5.5 sodium citrate buffer, although the initial recovered potency was lower for the 150 kDa BoNT/A (compare about 52%
initial recovered potency of the 150 kDa BoNT/A in Table 7 versus about 90% initial recovered potency of the 900-kDa BoNT/A toxin complex in Table 4). Similarly, recovery of the 150 kDa BoNT/A was observed in pharmaceutical compositions comprising PEG 3350 and/or Poloxamer 188 in about pH 5.5 potassium phosphate buffer, although the initial recovered potency was lower for the 150 kDa BoNT/A
(compare about 53% initial recovered potency of the 150 kDa BoNT/A in Table 7 versus about 98% initial recovered potency of the 900-kDa BoNT/A toxin complex in Table 4).

Table 7 Formulations using 150 kDa Botulinum Neurotoxina Excipient 1 Excipient 2 Recovered Ratio Solution Potencyb t..) 1¨
Type Amount Type Type Amountb -a, Poloxamer 188 50 ¨ ¨ ¨ Water (pH 6.5) 0 =
o Poloxamer 188 20 ¨ ¨ ¨ Water (pH 6.5) 0 Sucrose ¨ ¨ Water (pH 6.0) 0 Sucrose 60 Poloxamer 188 6 10:1 Water (pH 6.5) Lactose 60 ¨ ¨ Water (pH 4.4) 0 Lactose 60 Poloxamer 188 6 10:1 Water (pH 4.7) 110 n 1.) Dextran 40K 60 ¨ ¨ ¨ Water (pH 5.0) 0 FP

Dextran 40K 60 Poloxamer 188 6 10:1 Water (pH 5.8) 50 a, I.) o in Dextran 40K 60 Poloxamer 188 6 10:1 10 mM SC (pH 5.5) 46 I.) Dextran 40K 60 Poloxamer 188 6 10:1 10 mM SC (pH 7.2) H
H
I
Dextran 40K 60 Poloxamer 188 6 10:1 10 mM PP (pH 5.5) (5) Dextran 40K 60 Poloxamer 188 6 10:1 10 mM PP (pH 7.2) ko PEG 3350 60 ¨ ¨ ¨ Water (pH 6.6) 0 PEG 3350 60 ¨ ¨ ¨ 10 mM SC (pH 5.5) 0 PEG 3350 60 ¨ ¨ ¨ 10 mM PP (pH 5.5) 0 PEG 3350 60 Poloxamer 188 6 10:1 Water (pH 6.8) PEG 3350 60 Poloxamer 188 6 10:1 10 mM SC (pH 5.5) 52 1-d n PEG 3350 60 Poloxamer 188 6 10:1 10 mM SC (pH 7.2) PEG 3350 60 Poloxamer 188 6 10:1 10 mM PP (pH 5.5) 53 cp w o PEG 3350 60 Poloxamer 188 6 10:1 10 mM PP (pH 7.2) o -a a Amount of 150 kDa botulinum neurotoxin serotype A added per formulation was 150 units. Total o volume of formulation was 1.0 mL.
vi oe 'Table 7.
Formulations using 150 kDa Botulinum Neurotoxina ======================================
=====

Excipient 1 Excipient 2 Recovered Ratio Solutioe Potencyb Type Amount Type Type Amountb (o/
/0) b For Sucrose, Lactose, Trehalose, Raffinose, Mannitol, Inulin, Detran 3K, Detran 40K, PEG 3550, PVP17, Poloxamer 188, and Glycine, the unit amount of excipient added is in mg. For Polysorbate 20 and Polysorbate 80, the unit amount of excipient added is in mL.
c Buffer abbreviations are as follows: SC, sodium citrate buffer; PP potassium phosphate buffer; HB
histidine buffer; HPB, histidine phosphate buffer.
d Recovery is expressed as a percentage and is calculated by dividing the potency of the active ingredient determined after reconstitution divided by the potency of the active ingredient determined before addition to the formulation.

Ul -a oe Example 5 Non-Protein Stabilized Formulations ¨ Re-targeted Clostridia! Toxin
[0164] Experiments were carried out to prepare multiple formulations where the Clostridial toxin active ingredient contained in the formulations was a re-targeted Clostridial toxin (Table 8). The non-protein excipients tested were added separately or in combination with the listed buffers or salts (Table 8). All of the formulations were compounded, lyophilized, and reconstituted and potency assessed in the same manner, and with the same Clostridial toxin active ingredient used in each formulation, except that each formulation was prepared with different non-protein excipients or with different amounts of the non-protein excipients.
[0165] The tested formulations were compounded, processed, stored and reconstituted as described in Example 1, except that the Clostridial toxin active ingredient added was about 250 ng of a 100 kDa re-targeted BoNT/A, where the modification was the substitution of the BoNT/A
binding domain with an opiod ligand, see e.g., Steward, L.E. et al., Modified Clostridial Toxins with Enhanced Translocation Capabilities and Altered Targeting Activity For Non-Clostridial Toxin Target Cells, U.S. Patent Application No. 11/776,075 (Jul.
11, 2007); Dolly, J.O. et al., Activatable Clostridial Toxins, U.S. Patent Application No. 11/829,475 (Jul. 27, 2007); Foster, K.A. et al., Fusion Proteins, International Patent Publication WO 2006/059093 (Jun. 8,2006);
and Foster, K.A. et al., Non-Cytotoxic Protein Conjugates, International Patent Publication WO 2006/059105 (Jun. 8, 2006)
[0166] To determine the recovered potency of a retargeted Clostridial toxin, the reconstituted formulation was assayed for enzymatic activity by an in vitro light chain assay. In this assay, the solid formulation is reconstituted in 1.0 mL of digestion buffer comprising 2 mM DTT, 300 pM ZnCl2, and 50 mM HEPES (pH 7.4) and incubated at 37 C for 30 minutes. After the incubation, 500 pL the incubated formulation is transferred to a new tube and 5.0 pL of 200 pM of a quench-release fluorescent substrate (SNAPTIDE 520) was added.
This mixture is incubated at 30 C for about 18 to about 20 hours to allow for the Clostridial toxin active ingredient to digest the quench-release fluorescent substrate. The reaction is stopped by adding 25 pL of 5%
TFA to the digestion mixture. The quenched digestion mixture was then analyzed by routine reversed-phase high performance liquid chromatography (RP-HPLC) methods to separate and measure the amount of quench-release fluorescent substrate cleaved by the reconstituted formulation.
For this RP-HPLC analysis, the quenched digestion mixture was transferred to HPLC vials and 25 pL of this mixture was injected into the column (Waters SYMMETRY 300T" C18, 3.5 pm, 4.6 x 150 mm) set at a flow rate of 1.0 mUmin and a column temperature of 35 C. The run time was 20 minutes with a 5 minute injection delay. The gradient mobile phase was Solution A, comprising 0.1% TFA in water, and Solution B, comprising 0.1% TFA in acetonitrile. The gradient program was as follows: 0-10 munites 90% A and 10%.B, 10-15 minutes 80% A
and 20% B, and 15-20 minutes 100% B. The multi-wavelength fluorescent detector was set to an excitation wavelength of 322 nm and an emission wavelength of 420 nm and data was collected and analyzed using standard software. Cleavage products were identified by retention time using fluorescent detections and quantitated by peak area. Cleaved quench-release fluorescent substrate typically eluted at a retention time of 5.7 minutes.

'table it:
Formulations using Retargeted Clostridia! Toxin'.
Excipient 1 Excipient 2 Excipient 3 Recovered Potency (%) Ambient Below Freezing 18 1$: b Ratio Solutioe Temperaturef Temperature .. 'a vD
Type ::Amount Type Amount Type :Amount Initiale 12 3 12 o, months months months month* ---1 Sucrose 60 - - - - - Water (pH 6.5) 18/- -/- -/- -/- -/-Lactose 60 - - - - - Water (pH 6.5) 10/- -/- -/- -/- -/-Detran 40K 60 - - - - - Water (pH 6.5) 11/- -/- -/- -/- -/-PEG 3550 60 - - - - - Water (pH 6.5) 23/- -/- -/- -/- -/-10 mM SC (pH 5.5) 8/- -/- -/- -/- -/-10 mM PP (pH 5.5) 12/- -/- -/- -/- -/-o 100 mM HB (pH 5.9) 41/0 -/- -/- -/- -I.) -,1 PEG 3550 60 - - - - - 100 mM
HB (pH 5.9) / / / -I -PEG
(5) 22 mM ZnCl2 a,.
I.) vD
in o, 100 mM
HB (pH 5.9) / / / /-11 mM ZnCl2 I.) H
Polysorbate 20 0.5 - - - - -100 mM HB (pH 5.9) 101/101 -/- -/- 82/95 -/- H
I
g Polysorbate 20 0.5 - - - - - 100 mM HB (pH 5.9) 22 mM ZnCl2 ko Polysorbate 20 0.5 - - - - - 100 mM HB (pH 5.9) 11 mM ZnCl2 Polysorbate 20 0.5 - - - - - 100 mM HB (pH 5.9) 27 mM CaCl2 Polysorbate 20 0.5 - - - - - 100 mM HB (pH 5.9) - - 1-d 13.5 mM CaCl2 n ,-i Sucrose 20 Polysorbate 20 0.1 - - 200:1 10 mM PP (pH 7.0) 70/70 101/121 90/-101/121 -/- r, Sucrose 100 Polysorbate 20 0.5 - -200:1 50 mM PP (pH 7.0) 136/110 106/107 98/124 94/114 84/117 a Sucrose 60 Polysorbate 20 0.2 -- 300:1 25 mM HPB (pH 6.5) 106/- -/- -/- -/- -I-Sucrose 60 Polysorbate 20 0.5 - - 120:1 25 mM HPB (pH 6.5) 119/112 110/115 -/-91/120 86/114 21, Sucrose 27.3 Poloxamer 188 2.73 - - 10:1 25 mM SC (pH 5.5) 128/122 113/121 -/- -/- 77/- '3 Table 8 Formulations using Retargeted Clostridia! Toxin' Excipient 1 Excipient 2 Excipient 3 Recovered Potencya ___________ (%)0t..) o Ambient Below Freezing 18 Solution' Temperaturef Temperature Type Amountb Type Amountb Type Amount b Ratio Initial' µ
. ________________ yD
o 12 3 12 c7, months months months months ---1 Sucrose 27.3 Poloxamer 188 2.73 - - 10:1 10 mM PP (pH 7.0) 105/NT -/- -/- -/- -/-Sucrose 60 Poloxamer 188 2.73 22:1 25 mM HPB (pH 6.5) 111/104 109/109 -/- 93/109 Sucrose 20 Poloxamer 188 40 1:2 25 mM HPB (pH 6.5) 115/107 Sucrose 10 Polysorbate 20 0.1 Mannitol 10 100:1:100 10 mM SC (pH 5.5) 81/NT 100/100 -/--/- -/-Sucrose 15 Polysorbate 20 0.2 Mannitol 45 75:1:225 10 mM SC (pH 5.5) 72/121 68/80 -/-Sucrose 15 Polysorbate 20 0.1 Mannitol 60 150:1:600 10 mM SC (pH 5.5) 48/59 -/- -/- -/- -/- r) Sucrose 7.5 Polysorbate 20 0.1 Mannitol 22.5 75:1:225 10 mM PP (pH 7.0) 65/83 -/- -/- -I.) -,1 Sucrose 15 Polysorbate 20 0.2 Mannitol 45 75:1:225 10 mM PP (pH 7.0) 85/95 -/63 -/- -/- -/-(5) Sucrose 15 Polysorbate 20 0.2 Mannitol 45 75:1:225 25 mM HB (pH 6.5) 89/110 87/97 83/- -vD
I.) Sucrose 15 Poloxamer 188 2.73 Mannitol 45 5.5:1:16.5 25 mM SC (pH 5.5) 107/96 81/90 -/- -/- -/- I.) Sucrose 15 Poloxamer 188 2.73 Mannitol 45 5.5:1:16.5 25 mM HPB (pH 6.5) 110/103 100/100 -/-H
I

I
Lactose 55 Poloxamer 188 5.5 10:1 Water 60/0 -/- -/- -/- -/- 0 l0 Trehalose 60 Poloxamer 188 2.73 22:1 25 mM HB (pH 6.5) 107/123 116/115 98/-Trehalose 20 Poloxamer 188 40 1:2 25 mM HPB (pH 6.5) 125/112 Trehalose 20 Poloxamer 188 40 1:2 25 mM HPB (pH 6.5) 117/135 Trehalose 5 Poloxamer 188 55 1:11 10 mM HPB (pH 6.5) 99/132 -/- -/- 113/122 -/-Trehalose 10 Poloxamer 188 50 1:5 10 mM HPB (pH 6.5) 98/128 -/- -/-Trehalose 20 Poloxamer 188 40 1:2 10 mM HPB (pH 6.5) 99/127 -/- -/-109/121 -/- g Trehalose 30 Poloxamer 188 30 1:1 10 mM HPB (pH 6.5) 97/128 -/- -/-109/121 -/- iC.) Trehalose 40 Poloxamer 188 20 2:1 10 mM HPB (pH 6.5) 103/119 -/- -/-Trehalose 50 Poloxamer 188 10 5:1 10 mM HPB (pH 6.5) 95/125 -/- -/-111/112 -/- !I
Trehalose 5 Poloxamer 188 55 1:11 25 mM HPB (pH 6.5) 99/128 -/- -/- 113/123 -/- ipe Trehalose 10 Poloxamer 188 50 1:5 25 mM HPB (pH 6.5) 84/121 -/- -/-Table 8 Formulations using Retargeted Clostridia! Toxin' Excipient 1 Excipient 2 Excipient 3 Recovered Potencyd ___________ (%)0t..) o Ambient Below Freezing 18 1:1 b Ratio Solution' Temperaturef Temperature Type Amount Type Amountb Type Amount Initial' µ
. ________________ o o 12 3 12 o months months months months Trehalose 20 Poloxamer 188 40 ¨ ¨ 1:2 25 mM HPB (pH 6.5) 103/125 ¨/¨ ¨/¨ 112/125 ¨/¨

Trehalose 30 Poloxamer 188 30 1:1 25 mM HPB (pH 6.5) 98/122 ¨/¨ ¨/¨ 106/122 ¨/¨

Trehalose 40 Poloxamer 188 20 2:1 25 mM HPB (pH 6.5) 101/111 ¨/¨ ¨/¨ 98/118 ¨/¨

Trehalose 50 Poloxamer 188 10 5:1 25 mM HPB (pH 6.5) 97/116 ¨/¨ ¨/¨ 100/117 ¨/-25 mM HPB (pH 6.5) Trehalose 20 Poloxamer 188 40 1:2 112/134 102/¨ ¨/¨ ¨/¨ ¨/-26 mM NaCI
n Trehalose 20 Poloxamer 188 40 25 mM HPB
(pH 6.5) 1:2 110/140 104/¨ ¨/¨ ¨/¨ ¨/¨ I.) 51 mM NaCI
FP
25 mM HPB (pH 6.5) (5) a, Trehalose 20 Poloxamer 188 40 1:2 217/145 103/¨ ¨/¨ ¨/¨ ¨/¨ I.) o 77 mM NaCI in oe Trehalose 15 Polysorbate 20 0.2 Mannitol 45 75:1:225 25 mM PP (pH 7.0) 87/91 66/¨ ¨/¨ ¨/¨
¨/¨ "

H
Trehalose 15 Polysorbate 20 0.2 Mannitol 45 75:1:225 25 mM SC (pH 5.5) 89/97 59/77 ¨/¨ ¨/¨
¨/¨ H

Trehalose 15 Polysorbate 20 0.2 Mannitol 45 75:1:225 25 mM HB (pH 6.5) 85/114 60/96 ¨/¨
¨/¨ ¨/¨ (5) Trehalose 20 Polysorbate 20 0.2 PEG 3350 40 100:1:200 25 mM HPB (pH 6.5) 107/99 107/108 ¨/¨ 86/118 85/114 0 ko Trehalose 40 Polysorbate 20 0.5 PEG 3550 40 80:1:80 50 mM HB (pH 6.0)110/122 ¨/¨ ¨/¨
78/131 ¨/-11 mM ZnCl2 Trehalose 10 Polysorbate 20 0.2 PEG 3550 50 50:1:250 25 mM HPB (pH 6.5) 103/127 95/116 ¨/¨ 104/¨ ¨/¨

Trehalose 30 Polysorbate 20 0.2 PEG 3550 30 150:1:150 25 mM HPB (pH 6.5) 120/130 97/124 ¨/¨ 114/¨ ¨/¨

Trehalose 5 Polysorbate 20 0.2 PEG 3550 55 25:1:275 25 mM HPB (pH 6.5) 113/127 94/113 ¨/¨ 109/¨ ¨/¨ .0 25 mM HB (pH 5.9) Trehalose 5 Polysorbate 20 0.2 PEG 3550 55 25:1:275 119/126 ¨/¨ ¨/¨
103/111 ¨/¨ 7-i) 11 mM ZnCl2 cp w o Mannitol 30 Polysorbate 20 0.1 300:1 10 mM PP (pH 7.0) 38/38 ¨/¨ ¨/¨ ¨/¨ ¨/¨ S
'a Mannitol 60 Polysorbate 20 0.2 300:1 25 mM PP (pH 7.0) 60/59 52/44 ¨/¨ ¨/¨ ¨/¨
vi oe 'table it Formulations using Retargeted Clostridia! Toxin'.
Excipient 1 Excipient 2 Excipient 3 Recovered Potencyd (/o) Ambient Below Freezing o Ratio Solutioe Temperaturef Temperature Type ::Amount ,, Type :Amount Type ::Amountb initiaie 12 yD
o, months months months month ---1 PEG 3550 60 Polysorbate 20 0.5 ¨ ¨ 120:1 100 mM HB (pH 5.9) 120/136 ¨/¨
¨/¨ 70/130 ¨I¨
PEG100 mM HB (pH 5.9) 3550 60 Polysorbate 20 0.5 ¨ ¨ 120:1 121/118 ¨/¨ ¨/¨ 73/NA ¨/-22 mM ZnCl2 PEG 3550 60 Polysorbate 20 0.5 ¨
¨ 120:1 100 mM HB (pH 5.9)106/122 ¨/¨ ¨/¨
72/134 ¨/-11 mM ZnCl2 PEG 3550 60 Poloxamer 188 2.73 ¨
¨ 22:1 100 mM HB (pH 5.9) 104/118 ¨/¨ ¨/¨
¨/¨ ¨/¨ n 100 MM HB (pH 5.9) naiinA
PEG 3550 60 Poloxamer 188 2.73 ¨
¨ 22:1 uo/ i u=-i- ¨/¨ ¨/¨ ¨/¨ ¨/¨ 0 22 mM ZnCl2 "
-,1 FP
1 00 mM HB (pH 5.9) i nn / 4 i a cn PEG 3550 60 Poloxamer 188 2.73 ¨
¨ 22:1 i uu/ i i 0 ¨/¨ ¨/¨ ¨/¨ ¨/¨
o 11 mM ZnCl2 I.) o in a Amount of retarget Clostridial toxin added per formulation was 1-5 pg. Total volume of formulation was 1.0 mL. I.) H
H
I
b For Sucrose, Lactose, Trehalose, Raffinose, Mannitol, Inulin, Detran 3K, Detran 40K, PEG 3550, PVP17, Poloxamer 188, and Glycine, the unit amount of excipient 0 added is in mg. For Polysorbate 20 and Polysorbate 80, the unit amount of excipient added is in mL. (5) i ko c Buffer abbreviations are as follows: SC, sodium citrate buffer; PP potassium phosphate buffer; HB histidine buffer; HPB, histidine phosphate buffer.
d Recovery is expressed as a percentage and is calculated by dividing the potency of the active ingredient determined after reconstitution divided by the potency of the active ingredient determined before addition to the formulation. 3 months refers to the length of time a formulation was minimally stored at the indicated temperature. 12 months refers to the length of time a formulation was minimally stored at the indicated temperature.
1-d e The first number represents the value calculated form the in vitro light chain assay and the second number represents the value calculated form the ELISA. n ,-i f Ambient temperature is between about 18 C to about 22 0.
cp w o o g Below freezing temperature is between about -5 C to about -20 C.
o -a c., u, ,.,., oe
[0167] To determine the recovered potency of a retargeted Clostridial toxin, the reconstituted formulation was also assayed by the total amount of the Clostridial toxin active ingredient recovered using an enzyme-linked immunosorbant assay (ELISA). Microtiter plate used for the ELISA assay is coated with a primary polyclonal antibody (capture antibody) against 150 kDa BoNT/A (due to the presence of same epitopes for the re-targeted Clostridial toxin as in BoNT/A antibodies). After coating the antibody on a 96 well plate for 14-72 hours at 2-8 C, the test samples is added and incubated for 90 minutes at 25 C with gentle shaking. A
secondary antibody (capture antibody conjugated to Biotin molecules) is added and incubated for 60 minutes at 25 C with gentle shaking. After one hour incubation, and several washing steps Streptavidin-HRP
conjugate is added to the plate and incubate for another 60 minutes at 25 C
with gentle shaking. In the final step, after a few washing steps, a colorimetric substrate solution (TMB-Substrate) is added and incubate at room temperature for 5-7 minutes until the assay color is developed. The absorbance at 450 nm is measured by UV/Visible spectroscopy. The absorbance of the test sample is compared to a standard curve and the protein concentration is measured.
[0168] Recovery is expressed as a percentage and is calculated by dividing the potency of the Clostridial toxin active ingredient in the stored reconstitution formulation by the potency of the active Clostridial toxin ingredient determined prior to its addition into the test solution.
Clostridial toxin pharmaceutical composition comprising a re-targeted Clostridial toxin could be stabilized when the formulation comprised two or more non-protein excipients in a manner similar to the 900-kDa BoNT/A toxin complex and the 150 kDa BoNT/A.
[0169] The results showed that a Clostridial toxin pharmaceutical compositions comprising a sugar and a surfactant resulted in an effective initial recovered potency of the Clostridial toxin active ingredient. For example, Clostridial toxin pharmaceutical compositions comprising sucrose or lactose in combination with Poloxamer 188 resulted in recovered potency of the re-targeted Clostridial toxin similar to the results observed with the 900-kDa BoNT/A toxin complex (see Examples 1-3) and the 150 kDa BoNT/A (Example 4).
As another example, Clostridial toxin pharmaceutical compositions comprising sucrose in combination with Polysorbatew 20 resulted in high recovered potency of the re-targeted Clostridia! toxin (Table 8). As yet another example, Clostridial toxin pharmaceutical compositions comprising sucrose in combination with Poloxamer 188 resulted in high recovered potency of the re-targeted Clostridia! toxin (Table 8). As still another example, Clostridial toxin pharmaceutical compositions comprising trehalose in combination with Poloxamer 188 resulted in high recovered potency of the re-targeted Clostridia! toxin (Table 8). As another example, Clostridial toxin pharmaceutical compositions comprising trehalose in combination with PEG 3550 and Polysorbate 20 resulted in high recovered potency of the re-targeted Clostridia! toxin (Table 8).
[0170] The results also showed that a Clostridial toxin pharmaceutical compositions comprising a non-protein polymer and a surfactant also resulted in an effective initial recovered potency of the Clostridial toxin active ingredient. For example, Clostridial toxin pharmaceutical compositions comprising Dextran 40K or PEG 3550 in combination with Poloxamer 188 resulted in recovered potency of the re-targeted Clostridial toxin similar to the results observed with the 900-kDa BoNT/A toxin complex (see Examples 1-3) and the 150 kDa BoNT/A (Example 4).

Claims (14)

What is claimed:
1. A pharmaceutical composition comprising: (a) a botulinum toxin, wherein the botulinum toxin is not stabilized by a protein excipient, (b) a first compound selected from the group consisting of a first monosaccharide, a first disaccharide, a first trisaccharide, and a first alcohol made by reducing the first monosaccharide; and (c) a second compound selected from the group of compounds consisting of a second monosaccharide, a second disaccharide, a second trisaccharide, a metal, a second alcohol, and an amino acid, wherein the second monosaccharide, the second disaccharide and the second trisaccharide are different from respectively the first monosaccharide, the first disaccharide, and the first trisaccharide; and wherein the weight ratio of the first compound to the second compound is at least 15 to 1.
2. The pharmaceutical composition of claim 1, further comprising a polysorbate.
3. The pharmaceutical composition of claim 1, wherein the first disaccharide is sucrose.
4. The pharmaceutical composition of claim 1, wherein the amino acid is glycine.
5. The pharmaceutical composition of claim 1, wherein the amino acid is cysteine.
6. The pharmaceutical composition of claim 1, wherein the amino acid is methionine.
7. A pharmaceutical composition comprising: (a) a botulinum toxin, wherein the toxin is not stabilized by a protein excipient; (b) a first compound selected from the group consisting of a first monosaccharide, a first disaccharide, a first trisaccharide, and an amino acid; and (c) a second compound selected from the group of compounds consisting of a second monosaccharide, a second disaccharide, a second trisaccharide, a metal, and a surfactant, wherein the second monosaccharide, the second disaccharide and the second trisaccharide are different from respectively the first monosaccharide, the first disaccharide, and the first trisaccharide; wherein the weight ratio of the first compound to the second compound is at least 10 to 1.
8.
The pharmaceutical composition of claim 7, wherein the surfactant comprises a polysorbate.
9. The pharmaceutical composition of claim 7, wherein the surfactant is present in an amount of at least 0.03% (w/v).
10. The pharmaceutical composition of claim 7, wherein the amino acid is glycine.
11. The pharmaceutical composition of claim 7, wherein the amino acid is cysteine.
12. The pharmaceutical composition of claim 7, wherein the amino acid is methionine.
13. The pharmaceutical composition of claim 7, wherein the first disaccharide is sucrose.
14. The pharmaceutical composition of claim 13, wherein the weight ratio of the first disaccharide to the amino acid is at least 10 to 1.
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